U-shape incision on prostate capsule: New intraperitoneal laparoscopic technique in simple prostatectomy: A case report.

2021 
Abstract Introduction and importance: Laparoscopy is a known technique for simple prostatectomy using intraperitoneal or extraperitoneal approaches. In the present study, a novel method is suggested for easier access to the whole body and even the head of the adenoma. Case presentation This method was performed on 6 patients with prostate hyperplasia. This was intraperitoneal method, started with 4–6 trocars and two transverse incisions on both sides of the endopelvic fascia. the prostate capsule is detected (using a Foley catheter balloon); the prostate capsule is transversely opened by a U-shape incision in a 0.5–1cm distance from the bladder neck to reach the adenoma and is dissected under the capsule to separate the capsule from the prostate. By ligashour capsule is opened laterally to the endopelvic fascia and separated from the prostate and gland is removed. Clinical discussion The mean operation time was 114 minutes and the average intraoperative bleeding was 244.1 cc. IPSS (International Prostate Symptom Score), Q Max, and post-void residue, changes were significant with p-value = 0.003, respectively; however, pre and postoperative Hemoglobin was imprecise. The mean postoperative urinary leakage is reported at 22 cc. Conclusion In short, this technique provides a better vision to prostate adenoma and the results can be compared with other laparoscopic approaches. Yet, larger sample sizes in different centers are required for determining realistic results.
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