Laparoscopic Prostatectomy Intra- and Extraperitoneal Techniques

Laparoscopic Prostatectomy Intra- and Extraperitoneal Techniques George Ferzli, MD, FACS Robert Cacchione, MD; Paul Sayad, MD Department of Laparoscopic Surgery Staten Island University Hospital

Prostate Cancer Statistics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Methods of Treating Localized Prostate Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evolution of Laparoscopic Surgery for Prostate Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object]

Anatomy of the Prostate ,[object Object],[object Object],[object Object],[object Object],[object Object]

Prostatectomy: Analogy to Fundoplication esophageal tumor - prostate stomach - bladder esophagus - urethra vagus – neurovasc. bundle

Placement of Trocars ,[object Object],[object Object]

Placement of Trocars (Totally Extraperitoneal Technique)

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Step 1: Transperitoneal Access to Seminal Vesicles ,[object Object],[object Object]

Step 2: Dissection of the Prostatorectal Space ,[object Object],[object Object],[object Object]

Step 2: Lateral Dissection of Rectum vas deferens neurovascular bundle seminal vesicle urethra pubic bone ureter bladder rectum prostate dorsal vein

Step 3: Dissection of the Anterior Pubic Space ,[object Object],[object Object],[object Object],[object Object]

Step 3: Dissection of the Anterior Pubic Space

Step 3: Division of Dorsal Vein

Step 3: Section of Urethra at Prostatic Apex

Step 4: Mobilization of the Prostate ,[object Object],[object Object],[object Object]

Step 4: Sectioning of Anterior Bladder Neck

Step 4: Ureterovesicle Anastomosis

Laparoscopic Prostatectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Results of Laparoscopic Prostatectomy Schuessler. Urol. 50:854-57, 1997.

Results of Laparoscopic Prostatectomy Raboy, Albert, Ferzli. Surg Endosc. 12:1264-67, 1998.

The Last French Revolution ,[object Object],[object Object],[object Object],[object Object],[object Object]

The Next French Revolution ,[object Object],[object Object],[object Object],[object Object],[object Object]

Results of Laparoscopic Prostatectomy Guillonneau. J Urol 163:418-22, 2000.

Results of Laparoscopic Prostatectomy Abbou. Urol. 55:630-633, 2000.

Robotics in Urology ,[object Object]

Totally Extraperitoneal vs Transabdominal ,[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusions ,[object Object],[object Object]

Conclusions ,[object Object],[object Object],[object Object],[object Object]

Laparoscopic Prostatectomy Intra- and Extraperitoneal Techniques

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Laparoscopic Prostatectomy Intra- and Extraperitoneal Techniques