UroToday – Prospective evaluation of prostate cancer risk in candidates for inguinal hernia repair – Abstract

Prospective evaluation of prostate cancer risk in candidates for inguinal hernia repair

We found the incidence of concurrent prostate cancer with hernia to be low, but 51% of men had PSA values that suggested an increased relative risk of future development of prostate cancer. Men at increased risk of prostate cancer should be made aware of the impact that mesh might have on subsequent treatment options before mesh placement.

Many years ago it was thought that a prior laparoscopic hernia repair would be a major problem for a patient who had prostate cancer wanted a robotic prostatectomy.

Since 2003 the majority of robotic surgeons have performed robotic surgery through the abdominal cavity. With this approach, the bladder and blood vessels can safely be separated from the mesh with direct visualization.

I do not consider a prior hernia repair with mesh to be a significant concern prior to robotic surgery. The surgery should take a little longer, but removing the prostate is not a significant problem.

The only concern in patients that will undergo hernia repair is to make sure they do not have cancer at the present time. If they do and want surgery for prostate cancer, then a robotic hernia repair and robotic prostatectomy shoudl be done at the same time, avoiding 2 surgeries. I have performed over 100 of these combination hernia repairs and davinci prostatectomies.

Prostate Cancer Surgery: Open vs. Laparoscopic Prostatecomy Results

UroToday – EAU 2007 ABST[750] – Radical Prostatectomy: A non-randomized Comparative Analysis of Outcomes between the Open and Laparoscopic Approach

In our institution and during the study period, laparoscopic and retropubic radical prostatectomy provided comparable oncological efficacy, functional and morbidity outcomes.
The laparoscopic approach was associated with lesser blood loss and transfusion rate and higher postoperative hospital visits and readmission rate.

This was a good study by a high volume prostate cancer hospital.
I thought they had a higher rate of laparoscopic readmission rates that I would have expected, although the transfusion rate and blood loss was much less in the lap group.
I look forward to seeing how the robotic results compare to the open and lap data.