“Mini-Incision” Radical Prostatectomy?

2 May 2006 Prostate Cancer

In the February 2005 issue of UROLOGY, Dr. Miki et al from Kyoto, Japan descibes their initial experience using a running suture anastamosis during minilaparotomy radical retropubic prostatectomy for prostate cancer. They performed this anastamosis in 21 patients, utilizing a 6-cm midline incision. They used the Ethicon Endostitch device and a double-arm absorbable suture, starting at the 6 o’clock position. (similar to the priniciple used in the Van Velthoven anastamosis during robotic prostatectomy). Early continence was excellent among these 21 patients, but the initial 2 patients did develop early bladder neck contractures requiring dilation. Time to perform the anastamosis was 15 minutes on average.
Why post this on a robotic surgery blog? I think this is indicative of the trend in surgery towards minimally-invasive approaches. With the advancement of robotics & laparoscopy, “traditional” open surgeons are feeling compelled to minimize morbidity of their comparable open operations. However, I have issues with this minilaparotomy operation which I feel, erroneously, focuses on open & laparoscopic surgeons’ obsession with “incision size”.

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