Mediathek

Abstract

Stolzenburg, Jens-Uwe (Leipzig)
Do, Minh (Leipzig), Dorschner, Wolfgang (Leipzig), Pfeiffer, Heidemarie (Leipzig), Rabenalt,
Robert (Leipzig)

Endoscopic Extraperitoneal Radical Prostatectomy (EERPE)

Since the first description of laparoscopic radical prostatectomy the technique has undergone
significant technical modifications. Transperitoneal laparoscopic radical prostatectomy is today
a standardised procedure and can be successfully performed with results comparable to the open
retropubic procedure. Despite many advantages, transperitoneal laparoscopy is associated with
potential intraperitoneal complications. Due to these limitations inherent to the
transperitoneal route the technique of endoscopic extraperitoneal radical prostatectomy (EERPE)
has been developed.
This DVD (Audio-visual Tutorial EERPE step-by-step) shows our technique of endoscopic
extraperitoneal radical retropubic prostatectomy for treating localized prostate cancer step by
step and aims to demonstrate its feasibility and reproducibility.
The steps of the procedure are the following: preparation of the preperitoneal space, trocar
placement, pelvic lymph node dissection, exposure of the prostate and the bladder neck, incision
of endopelvic fascia, ligation of the Santorini?s plexus, bladder neck dissection, mobilization
of seminal vesicles, incision of Denonvillier’s fascia, sectioning of prostatic pedicles,
dissection of Santorini?s plexus and apex, urethrovesical anastomosis, removing of the specimen
via endobag.
Although the working space within the preperitoneal space is a little more restricted than in
the abdominal cavity and orientation is more difficult at the beginning of the procedure, the
ultimate result is a procedure completely avoiding intraperitoneal complications. Therefore, the
EERPE seems to present a technical improvement over laparoscopic transperitoneal radical
prostatectomy because EERPE combines the advantages of laparoscopy and the open retropubic
approach.