Laparoscopy for BPH therapy

Lap technique may play a role in treating BPH – UrologyTimes

Berlin—A laparoscopic preperitoneal approach cannot only serve as a teaching platform for laparoscopic skills for surgeons, but it also demonstrates reproducible outcomes in the treatment of BPH, according to Belgian researchers who presented their results at the European Association of Urology annual congress here.
Researchers from the Institut Jules Bordet, Universite Libre de Bruxelles in Brussels, conducted a 102-patient prospective study comparing a classical open Millin’s retropubic transcapsular adenectomy in 51 patients and a laparoscopic preperitoneal approach in 52 patients according to a step-by-step transposition of Millin’s procedure described in European Urology (2004; 45:103-9).
Preoperative characteristics were comparable between the groups with respect to age, prostate volume measured by trans-rectal ultrasonography, preoperative micturition, post-void residual volume, and International Prostate Symptom Score (IPSS).

This study was done with laparoscopy and looked at open vs laparoscopic prostatectomy for BPH for smaller prostates.
I have performed over 10 robotic prostatectomies for BPH with over 150 grams of tissue removed on many men. I think the robotic approach is harder to learn than either of the 2 above methods, but when mastered, leads to an easier and quicker operation.





2 responses to “Laparoscopy for BPH therapy”

  1. kurt Avatar

    thank you for the post – where will the future application of robotic surgery besides urology?

  2. Domenico Savatta, MD Avatar

    In Urology robotics is very well accepted in prostate cancer surgery and is starting to be accepted broadly in bladder cancer surgery.
    Eventually most large urologic surgery will be done this way.
    The next large growth are is GYNECOLOGY. Most hysterectomies and myomectomies will be done this way first, then other gyn procedures may follow.
    I think esophageal and stomach surgery including bypass surgery will have a large percentage being done robotically.
    Cardiac: Some CABG and valve surgery will be done this way.
    Thoracic: Some lung resections and lymph node removals and esophagus surgery.
    Telerobotics and likely incisionless surgery using the natural orifices will be done as well.
    Some of this will be because it is better and some will be by patient demand. Also, the cost of robotics will go down eventually.