Laparoscopic radical prostatectomy: Experience in 312 cases.

Introduction: Laparoscopic radical prostatectomy (LRP) is emerging as an attractive treatment option for patients with organ confined prostate cancer. Initially this modality was available only at select centers; however more and more centers are now offering this modality. LRP is a technically complex operation and should ideally be attempted only after significant laparoscopic experience. Materials and Methods: A retrospective chart review was performed of 312 cases of LRP performed by the author between January 2003 and March 2007. Standard transperitoneal 5 port LRP was performed in all patients. Mean age was 66.5 years (53-71), mean Gleason score was 7 (6-9), mean weight of the patient was 184 lbs (140-288), and mean prostate size was 36 grams (20-78). Results: LRP was successful in 310 of 312 cases. 2 patients required open conversion. Mean operating time was 210 minutes (150-350), mean blood loss was 166 cc (50-1000), mean time to complete the anastomosis was 38.5 minutes (25-55), mean hospital stay was 2.2 days (1-7), mean catheter duration was 12.5 days (7-21). There were a total of 26 (8.3%) minor complications and 6 (1.9%) major complications. Minor complications included ileus (4), DVT (9), post operative hemorrhage not requiring transfusion (4), localized urine leak (6), and reinsertion of catheter after accidental slippage (3). Major complications included rectal perforation (1), major urine leak (3) and post operative hemorrhage requiring exploration (2). Positive margin rate was 14%. Conclusions: LRP is a technically challenging procedure but in experienced hands provides significant benefits to patients over open surgery. [ABSTRACT FROM AUTHOR]