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• W2313697053 abstract "You have accessJournal of UrologyProstate Oncology1 Apr 2012V1243 LAPAROSCOPIC RESOLUTION OF COMPLICATIONS DURING RADICAL PROSTATECTOMY Roberto Sanseverino, Giorgio Napodano, Olivier Intilla, Umberto Di Mauro, and Tommaso Realfonso Roberto SanseverinoRoberto Sanseverino Nocera Inferiore, Italy More articles by this author , Giorgio NapodanoGiorgio Napodano Nocera Inferiore, Italy More articles by this author , Olivier IntillaOlivier Intilla Nocera Inferiore, Italy More articles by this author , Umberto Di MauroUmberto Di Mauro Nocera Inferiore, Italy More articles by this author , and Tommaso RealfonsoTommaso Realfonso Nocera Inferiore, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1547AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since its introduction, Laparoscopic preperitoneal radical prostatectomy (LPPRP) is undergoing continuous refinements which make it today a feasible, reproducible, and teachable operation. Nevertheless intraoperative complications require often conversion to open surgery. The video shows a laparoscopic resolution of a rectal injury and of an external iliac vein lesion during preperitoneal radical prostatectomy. METHODS After creating the preperitoneal space by balloon trocar dissection, five trocars (2 x 5mm and 3 x 10mm port) are placed in the hypogastrium. Bilateral pelvic lymphadenectomy is performed. Bilateral incision of endopelvic fascia anticipates haemostatic transacted suture of Santorini plexus with Vicryl™. Bladder neck dissection. Urethra is then transected. Vas deferens are isolated and then cutted; mobilization of seminal vesicles precedes incision of the Denonvilliers' fascia. Section of the prostatic pedicles is routinely realized with Ligasure™ or with Hem-O-lock and endoshears, when a nerve sparing technique is performed. Because of strong adhesion between prostate and rectum an injury of the anterior rectal wall occurs. After cutting Santorini plexus and urethra, the prostate is placed in endobag. The rectal lesion is repaired with Vicryl™ sutures. A sponge of Tachosil™ is applied on the repaired rectal wall using a laparoscopic dedicated device. In the second case the video shows a lesion of right external iliac vein occurred during removal of a needle from abdominal cavity. The vein is isolated and clamped by a self made tourniquet. The lesion is repaired with a Prolene suture. A Surgicel™ sheet is applied on the vein. Bladder neck biopsy and water-tight urethrovesical anastomosis with double running suture as described by van Velthoven are performed. RESULTS In both cases the laparoscopic surgical procedure is realized without any major consequences. CONCLUSIONS The LPPRP is feasible and reproducible technique that could be subject to intraopeative complications requiring conversion to open surgery. Nevertheless it is possible resolve, also during learning curve, major complications as rectal and vascular injuries without conversion to open surgery. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e502 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roberto Sanseverino Nocera Inferiore, Italy More articles by this author Giorgio Napodano Nocera Inferiore, Italy More articles by this author Olivier Intilla Nocera Inferiore, Italy More articles by this author Umberto Di Mauro Nocera Inferiore, Italy More articles by this author Tommaso Realfonso Nocera Inferiore, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2313697053 title "V1243 LAPAROSCOPIC RESOLUTION OF COMPLICATIONS DURING RADICAL PROSTATECTOMY" @default.
• W2313697053 doi "https://doi.org/10.1016/j.juro.2012.02.1547" @default.
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