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All about Laparosocpic radical prostatectomy

  • Posted on- Jan 06, 2018
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Laparoscopic radical prostatectomy can be described as a form of prostate cancer. Contrasted with the original open form of the surgery, it does not make any large incision instead it uses fiber optics and miniaturization.

The laparoscopic prostatectomy is performed by removing the entire prostate and then reconstruction of the urethra is done which is linked directly to the bladder. Laparoscopic radical prostatectomy and open radical prostatectomy differ in how they access the deep pelvis and generate operative views. With the help of laparoscopic prostatectomy, there will be no use of retractors, abdominal wall will not be parted away and operation will be completed before time.

What is the procedure of laparoscopic radical prostatectomy?

Time taken by this procedure can be as long as 8 hours for the average urologist, without a bilateral lymph node dissection, compared to 2.5 to 3 hours when done by an open technique with an incision, with a completed lymph node dissection.

What is the success rate of laparoscopic radical prostatectomy?

There is a robotic and non-robotic version. There can be a small unclear difference in these two versions in cancer-related terms. For the robotic laparoscopic surgery can be a long learning curve for the robotic procedure. According to estimation if a doctor needs to get in a comfortable state, he/she is required to perform 60 cases randomly and about 250 cases to be an expert.

How long did you have to stay after the operation in the hospital?

A majority of patients are discharged one day after a laparoscopic prostatectomy. However, the time of discharge is decided on the case by case basis. By the second night, over 90% of patients are comfortable enough to go home.

 

How long is a catheter needed after the operation?

For open surgery, the catheter is removed after 2 to 3 weeks. The removal of the catheter is done after 7 days of laparoscopic prostatectomy. This is done with the assistance of an X-ray in order to check the status of the site where the urethra has been connected to the bladder.

Will there any leakage after laparoscopic radical prostatectomy?

For the first few weeks, it’s recommended to wear a protective pad. Continuity doesn’t take much time to arrive at its early time, over 95 % of patients have full control of their urination. Kegel exercise helps the patient from recovering with mild stress urinary incontinence.

What are the risks of laparoscopic radical prostatectomy?

In some cases, there can be a greater risk of accidental risk of getting into the prostate, resulting in "margin positivity," which means the cancer is left out in that same organ by the experts. This is presumed to happen as a result of the lack of tactile sensation. Small positivity is strongly correlated with PSA recurrences and a fourfold annual increase in cancer recurrence compared to men with negative surgical margins.

The greater risk of laparoscopic radical prostatectomy can be due to the surgery performed robotically which does not give the accuracy. The rationale usually given is that patient selection is such that most patients with Gleason score 6 on pathology did not need a lymphadenectomy.

However, a small number of patients with Gleason 6 adenocarcinoma of the prostate are upgraded to Gleason 7 on final pathology. Any micrometastases in lymph nodes would not be detected, not be removed and would increase the risk of recurrences.

Laparoscopic radical prostatectomy minimum cost for Rs. 3,80,000 to maximum Rs. 7,60,000.

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