Evaluation of the Effectiveness of a Novel Technique for Laparoscopic Radical Prostatectomy

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BACKGROUND: Radical prostatectomy remains the primary surgical treatment for patients with localized prostate cancer. Regardless of the surgical approaches, the risk of complications persists. Therefore, improving the technique of radical prostatectomy remains a pressing issue in uro-oncology.

AIM: To evaluate the effectiveness of a novel technique for laparoscopic radical prostatectomy in patients with localized prostate cancer.

METHODS: An analysis of surgical treatment was performed in 137 patients with localized prostate cancer. Laparoscopic radical prostatectomy was performed in all patients: 80 patients (group 1) underwent the procedure using a modified technique with preservation of the pelvic supportive ligamentous structures, and 57 patients (group 2) — using the standard technique.

RESULTS: Patients in group 1 demonstrated shorter total operative time, reduced intraoperative blood loss, and a decreased duration of urinary bladder drainage via urethral catheter. Earlier recovery of spontaneous urination was associated with a shorter postoperative hospital stay. On average, patients in group 1 had a 1.4-fold shorter hospitalization compared to those in group 2.

CONCLUSION: A new technique for extraperitoneal laparoscopic radical prostatectomy with preservation of the pelvic supportive ligamentous structures has been developed, implemented, and clinically tested in patients with localized prostate cancer. Further research is warranted to assess long-term surgical outcomes.

Full Text

Restricted Access

About the authors

Denis I. Volodin

State Research Center — Burnasyan Federal Medical Biophysical Center

Author for correspondence.
Email: vmeda@ya.ru
ORCID iD: 0000-0002-9489-6746
SPIN-code: 3043-3266
Russian Federation, Moscow

Fedor A. Sevryukov

Privolzhsky Research Medical University

Email: fedor_sevryukov@mail.ru
ORCID iD: 0000-0001-5120-2620
SPIN-code: 5508-5724

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Nizhny Novgorod

Aleksey V. Krupin

Privolzhsky Research Medical University

Email: alval.krupin@gmail.com
ORCID iD: 0000-0001-9584-756X
SPIN-code: 4064-2757

MD, Cand. Sci. (Medicine)

Russian Federation, Nizhny Novgorod

Valentin N. Krupin

Privolzhsky Research Medical University

Email: vn.krupin@mail.ru
ORCID iD: 0000-0002-4887-4888
SPIN-code: 8892-7661

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Nizhny Novgorod

References

  1. Sevryukov FA, Malinina OYu, Elina YuA. Peculiar features of morbidity of the population with disordes of the genitourinary sistem and diseases of the prostate gland, in particular, in the Russian Federation, in the Privolzhsky (Volga) Federal District, and in the Nizhni Novgorod Region. Social Aspects оf Population Health. 2011;(6):8. EDN: OPGNQF
  2. Kaprin AD, Starinsky VV, Shakhzadova AO. Malignant neoplasms in Russia in 2020 (morbidity and mortality). MNIOI im. P.A. Hertsen; 2021:252.
  3. Pernar CH, Ebot EM, Wilson KM, et al. The epidemiology of prostate cancer. Cold Spring Harb Perspect Med. 2018;8(12):a030361. doi: 10.1101/cshperspect.a030361 EDN: UMPYDS
  4. Gritskevich AA, Medvedev VL, Kostin AA, et al. Prognostic factors of survival in patients with prostate cancer. Experimental & Clinical Urology. 2017;4:12–19. doi: 10.29188/2222-8543 EDN: YNJPFS
  5. Cornford P, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer-2024 update. Part I: Screening, diagnosis, and local treatment with curative intent. Eur Urol. 2024;86(2):148–163. doi: 10.1016/j.eururo.2024.03.027 EDN: PIUSGN
  6. Moretti TBC, Magna LA, Reis LO. Radical prostatectomy technique dispute: analyzing over 1.35 million surgeries in 20 years of history. Clin Genitourin Cancer. 2023;21(4): e271–e278.e42. doi: 10.1016/j.clgc.2023.02.005 EDN: ZWYJSJ
  7. Pompe RS, Beyer B, Haese A, et al. Postoperative complications of contemporary open and robot-assisted laparoscopic radical prostatectomy using standardised reporting systems. BJU Int. 2018;122(5):801–807. doi: 10.1111/bju.14369 EDN: BDRJBU
  8. Haeuser L, Reese SW, Paciotti M, et al. Surgical complications requiring intervention in open versus minimally invasive radical prostatectomy. Urol Int. 2022;106(1):51–55. doi: 10.1159/00051561816-19 EDN: ZFTSSR
  9. Al-Shukri SKh, Nevirovich ES, Kuzmin IV, et al. Early and late complications of radical prostatectomy. Urology Reports (St. Petersburg). 2012;2(2):10–14. doi: 10.17816/uroved2210-14 EDN: PZHTET
  10. Isaev OA, Kyzlasov PS, Sergeev VP, et al. Intra- and early postoperative complications of laparoscopic and robot-assisted radical prostatectomy. Urology Reports (St. Petersburg). 2024;14(3):351–358. doi: 10.17816/uroved635161 EDN: FMVSBC
  11. Kowalewski KF, Tapking C, Hetjens S, et al. Interrupted versus continuous suturing for vesicourethral anastomosis during radical prostatectomy: a systematic review and meta-analysis. Eur Urol Focus. 2019;5(6):980–991. doi: 10.1016/j.euf.2018.05.009 EDN: ZZKMUR
  12. Ryabov MA, Byadretdinov ISh, Kotov SV Robot-assisted and laparoscopic radical prostatectomy learning curve. Experimental & Clinical Urology. 2021;14(4):37–43. doi: 10.29188/2222-8543-2021-14-4-37-43 EDN: THLXDC
  13. Gorelova AA, Petrov SB, Berkut MV, et al. Comparative analysis of the outcomes of laparoscopic radical prostatectomy and initial experience with robot-assisted radical prostatectomy. Urology Reports (St. Petersburg). 2024;14(4):391–396. doi: 10.17816/uroved631870 EDN: BZGEAE

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. The stages of standard laparoscopic radical prostatectomy: a — opening of the intrathecal fascia; b — crossing of the neck of the bladder; c — mobilization of the seminal complex; d — opening of the fascia of Denonvillier; e — crossing of the legs of the prostate; f — crossing and stitching of the dorsal venous complex; g — apical dissection; h — formation of the urethrovesical anastomosis.

Download (502KB)
Indexing metadata
3. Fig. 2. Stages of radical prostatectomy with preservation of the ligamentous apparatus of the small pelvis: a — mobilization of the bladder neck; b — mobilization of the seminal complex; c — opening of the Denonvillier fascia; d — mobilization of the intrathecal fascia of the levator and periprostatic fascia (1 — neurovascular bundle; 2 - periprostatic fascia; 3 — intrathecal fascia; 4 — mesorectum); e — mobilization of the dorsal venous complex (1 — periprostatic fascia; 2 — intratase fascia; 3 — tendon arch of the pelvis); f — apical dissection (1 — apex of the prostate; 2 — pubic articulation of the prostate; 3 — intratase fascia and dorsal venous complex, detrusor apron; 4 — levator); g — intersection of the urethra (1 — urethra; 2 — urethral sphincter; 3 — intratase fascia, dorsal venous complex; 4 — levator); h — urethral-vesical anastomosis (1 — urethra; 2 — neck of the bladder i — anterior reconstruction (1 — urethra; 2 — urethral sphincter; 3 — intratase fascia, dorsal venous complex, detrusor; 4 — detrusor of the bladder).

Download (583KB)
Indexing metadata

Copyright (c) 2025 Eco-Vector

License URL: https://eco-vector.com/for_authors.php#07
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 89281 от 21.04.2025.