Laparoscopic radical prostatectomy: First intervention in Colombia Prostatectomía radical laparoscópica: Primera intervención en Colombia

Abstract

Worldwide, the first publication of a major laparoscopic procedure in urology was performed by Ralph Claymann in 1991 and it was a nephrectomy. Three years later, in July 1993, the same procedure was performed at the Hospital de San José. The first laparoscopic radical prostatectomy was described in 1992 by Schuessler and colleagues, who in 1997 reported a series of nine cases without demonstrating benefits superior to those of the conventional procedure. It was in 1999, when Guillonneau and Vallancien reported a series of 65 patients where they described the technique and demonstrated low morbidity, offering a surgical alternative to patients with prostate cancer. We present the first case of laparoscopic radical prostatectomy performed in Colombia by the Urology Department of the Hospital of San José, in a 60-year-old patient with a T2bNxMO prostate adenocarcinoma; the surgical time was five hours, without transfusion and discharged on the first postoperative day. There are many advantages of laparoscopic surgery in relation to open surgery, such as decreased bleeding due to the excellent visibility of the dorsal complex and the tamponade effect of pneumoperitoneum pressure during surgery. The continence and narrow indexes of the anastomosis are comparable in the different open and laparoscopic series, as well as the positive margin rate. In the same way, having a magnification of the neurovascular bundles, there is a better preservation of them with good posterior erectile response. In conclusion, laparoscopic radical prostatectomy is a novel procedure, with better preservation of the nerve bundles and less bleeding, shorter hospital stay and faster recovery, with less need for analgesics, and also, an early labor reincorporation.