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• W2169739161 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2001LAPAROSCOPIC RADICAL PROSTATECTOMY WITH THE HEILBRONN TECHNIQUE: AN ANALYSIS OF THE FIRST 180 CASES JENS RASSWEILER, LUDGER SENTKER, OTHMAR SEEMANN, MARTIN HATZINGER, and HANS JOACHIM RUMPELT JENS RASSWEILERJENS RASSWEILER More articles by this author , LUDGER SENTKERLUDGER SENTKER More articles by this author , OTHMAR SEEMANNOTHMAR SEEMANN More articles by this author , MARTIN HATZINGERMARTIN HATZINGER More articles by this author , and HANS JOACHIM RUMPELTHANS JOACHIM RUMPELT More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65514-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In 1998 Guillonneau and Vallancien introduced laparoscopic radical prostatectomy with primary access to the seminal vesicle. In 1999 we developed a different laparoscopic technique similar to the classic retropubic radical prostatectomy. We focus on early results and the learning curve of the procedure in the first 180 patients. Materials and Methods: A transperitoneal approach is used with immediate access to Retzius’ space. After the dorsal vein complex is endoscopically sutured, the urethra is incised and distal pedicles of the prostate with or without the neurovascular bundle transected. The apex is then pulled ventrally followed with incision at the bladder neck, and transvesical access to vas deferens and seminal vesicle. After completing the posterior wall of the urethrovesical anastomosis with 5 interrupted endoscopic sutures, the Foley catheter is placed, bladder neck closed and specimen extracted via the umbilical incision. From March 1999 to December 2000 we have performed 180 procedures, including 3 for stage pT1 tumor, 88 pT2, 82 pT3 and 7 pT4. Mean preoperative PSA was 13.3 ng./ml. (range 1.4 to 148), mean specimen weight 37.4 gm. (10 to 125) and median Gleason score 6 (3 to 9). For evaluation of the learning curve a separate analysis of 3 groups with 60 patients in each was done. Differences between groups 1 (first 60 patients) and 3 (last 60) were analyzed for statistically significant differences. Results: Mean operating time was 271 minutes (range 150 to 500) and transfusion rate 31%. The reintervention rate was 4.4% and complication rate 18.8%. Of the patients 92% did not require any analgesia on postoperative day 2. Positive margins were found in 16% of the patients. The rate of positive margins in pT2 tumors was 2.3%, pT3a 15% and pT3b 34%. After a median followup of 12 months (range 3 to 23) in 9 (5%) patients a prostate specific antigen relapse was observed. The anastomosis was tight after removal of the catheter in 83% of patients, with a median time of 7 days (range 5 to 30). An anastomotic stricture had to be treated with laser incision in 3.3% of patients. On discharge from the hospital 33% of patients were continent, after 6 months 74% and after 12 months 97%. Analysis of the learning curve revealed significant differences in operating time (324 versus 265 minutes), conversion rate to open surgery (8.1% versus 1.7%), complication rate (23.3% versus 11.7%) and rate of prolonged catheterization (31.6% versus 10%, respectively), whereas the percentage of positive margins and continence rates showed no influence. Conclusions: Laparoscopic radical prostatectomy requires significant laparoscopic expertise with an ongoing learning curve. Morbidity is low, oncological control similar to results of open surgery and functional results are promising. The procedure should be performed only at dedicated centers with adequate training and expertise. References 1 : Laparoscopic radical prostatectomy: initial case report. J Urol, suppl.1992; 147: 246A. abstract 130. 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Link, Google Scholar From the Department of Urology and Pathology, Klinikum Heilbronn, University of Heidelberg, Heilbronn, Germany© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMaldonado-Valadez R, Teber D, Erdogru T, Safi K, Frede T and Rassweiler J (2018) The Impact of Neoadjuvant Hormonal Therapy on the Outcome of Laparoscopic Radical Prostatectomy: A Matched Pair AnalysisJournal of Urology, VOL. 175, NO. 6, (2092-2096), Online publication date: 1-Jun-2006.Tooher R, Swindle P, Woo H, Miller J and Maddern G (2018) Laparoscopic Radical Prostatectomy for Localized Prostate Cancer: A Systematic Review of Comparative StudiesJournal of Urology, VOL. 175, NO. 6, (2011-2017), Online publication date: 1-Jun-2006.ERDOGRU T, TEBER D, FREDE T, MARRERO R, HAMMADY A and RASSWEILER J (2018) THE EFFECT OF PREVIOUS TRANSPERITONEAL LAPAROSCOPIC INGUINAL HERNIORRHAPHY ON TRANSPERITONEAL LAPAROSCOPIC RADICAL PROSTATECTOMYJournal of Urology, VOL. 173, NO. 3, (769-772), Online publication date: 1-Mar-2005.RASSWEILER J, SCHULZE M, TEBER D, MARRERO R, SEEMANN O, RUMPELT J and FREDE T (2018) LAPAROSCOPIC RADICAL PROSTATECTOMY WITH THE HEILBRONN TECHNIQUE: ONCOLOGICAL RESULTS IN THE FIRST 500 PATIENTSJournal of Urology, VOL. 173, NO. 3, (761-764), Online publication date: 1-Mar-2005.TRABULSI E and GUILLONNEAU B (2018) LAPAROSCOPIC RADICAL PROSTATECTOMYJournal of Urology, VOL. 173, NO. 4, (1072-1079), Online publication date: 1-Apr-2005.PATEL V, TULLY A, HOLMES R and LINDSAY J (2018) ROBOTIC RADICAL PROSTATECTOMY IN THE COMMUNITY SETTING—THE LEARNING CURVE AND BEYOND: INITIAL 200 CASESJournal of Urology, VOL. 174, NO. 1, (269-272), Online publication date: 1-Jul-2005.FREDE T, ERDOGRU T, ZUKOSKY D, GULKESEN H, TEBER D and RASSWEILER J (2018) COMPARISON OF TRAINING MODALITIES FOR PERFORMING LAPAROSCOPIC RADICAL PROSTATECTOMY: EXPERIENCE WITH 1,000 PATIENTSJournal of Urology, VOL. 174, NO. 2, (673-678), Online publication date: 1-Aug-2005.ROZET F, GALIANO M, CATHELINEAU X, BARRET E, CATHALA N and VALLANCIEN G (2018) EXTRAPERITONEAL LAPAROSCOPIC RADICAL PROSTATECTOMY: A PROSPECTIVE EVALUATION OF 600 CASESJournal of Urology, VOL. 174, NO. 3, (908-911), Online publication date: 1-Sep-2005.CATHELINEAU X, CAHILL D, WIDMER H, ROZET F, BAUMERT H and VALLANCIEN G (2018) Transperitoneal or Extraperitoneal Approach for Laparoscopic Radical Prostatectomy: A False Debate Over a Real ChallengeJournal of Urology, VOL. 171, NO. 2, (714-716), Online publication date: 1-Feb-2004.CHANG S, DUONG D, WELLS N, COLE E, SMITH J and COOKSON M (2018) Predicting Blood Loss and Transfusion Requirements During Radical Prostatectomy: The Significant Negative Impact of Increasing Body Mass IndexJournal of Urology, VOL. 171, NO. 5, (1861-1865), Online publication date: 1-May-2004.LINK R, SU L, BHAYANI S and PAVLOVICH C (2018) MAKING ENDS MEET: A COST COMPARISON OF LAPAROSCOPIC AND OPEN RADICAL RETROPUBIC PROSTATECTOMYJournal of Urology, VOL. 172, NO. 1, (269-274), Online publication date: 1-Jul-2004.RASSWEILER J, SEEMANN O, SCHULZE M, TEBER D, HATZINGER M and FREDE T (2018) Laparoscopic Versus Open Radical Prostatectomy: A Comparative Study at a Single InstitutionJournal of Urology, VOL. 169, NO. 5, (1689-1693), Online publication date: 1-May-2003.KATZ R, SALOMON L, HOZNEK A, de la TAILLE A, ANTIPHON P and ABBOU C (2018) Positive Surgical Margins in Laparoscopic Radical Prostatectomy: The Impact of Apical Dissection, Bladder Neck Remodeling and Nerve PreservationJournal of Urology, VOL. 169, NO. 6, (2049-2052), Online publication date: 1-Jun-2003.STOLZENBURG J, DO M, RABENALT R, PFEIFFER H, HORN L, TRUSS M, JONAS U and DORSCHNER W (2018) Endoscopic Extraperitoneal Radical Prostatectomy: Initial Experience after 70 ProceduresJournal of Urology, VOL. 169, NO. 6, (2066-2071), Online publication date: 1-Jun-2003.GETTMAN M, HOZNEK A, SALOMON L, KATZ R, BORKOWSKI T, ANTIPHON P, LOBONTIU A and ABBOU C (2018) Laparoscopic Radical Prostatectomy: Description of the Extraperitoneal Approach Using the da Vinci Robotic SystemJournal of Urology, VOL. 170, NO. 2, (416-419), Online publication date: 1-Aug-2003.AHLERING T, SKARECKY D, LEE D and CLAYMAN R (2018) Successful Transfer of Open Surgical Skills to a Laparoscopic Environment Using a Robotic Interface: Initial Experience With Laparoscopic Radical ProstatectomyJournal of Urology, VOL. 170, NO. 5, (1738-1741), Online publication date: 1-Nov-2003.KATZ R, SALOMON L, HOZNEK A, de la TAILLE A, VORDOS D, CICCO A, CHOPIN D and ABBOU C (2018) Patient Reported Sexual Function Following Laparoscopic Radical ProstatectomyJournal of Urology, VOL. 168, NO. 5, (2078-2082), Online publication date: 1-Nov-2002.Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, Peabody J and Vallancien G (2018) Laparoscopic and Robot Assisted Radical Prostatectomy: Establishment of a Structured Program and Preliminary Analysis of OutcomesJournal of Urology, VOL. 168, NO. 3, (945-949), Online publication date: 1-Sep-2002. Volume 166Issue 6December 2001Page: 2101-2108 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordslaparoscopyprostatic neoplasmsprostatectomyprostateMetricsAuthor Information JENS RASSWEILER More articles by this author LUDGER SENTKER More articles by this author OTHMAR SEEMANN More articles by this author MARTIN HATZINGER More articles by this author HANS JOACHIM RUMPELT More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2169739161 title "LAPAROSCOPIC RADICAL PROSTATECTOMY WITH THE HEILBRONN TECHNIQUE: AN ANALYSIS OF THE FIRST 180 CASES" @default.
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