Finger Assisted Laparoscopic Retropubic Prostatectomy (Millin)

BackgroundWe performed more than 450 laproscopic retropubic prostatectomy procedures since 2001.ObjectiveTo describe the Finger Assisted Laparoscopic Retropubic technique (FALRP) in the treatment of large adenoma. We present the results of the last 100 procedures using FALRP.Materials and methodsFrom January 2004 to October 2005, 100 patients with indication of prostatic adenomectomy were operated on FALRP. Preoperative, perioperative and post operative parameters were collected retrospectively. Complications and risk factors were also evaluated.ResultsMean age of the patients was 67.84 years (SD 7.62) and mean BMI was 25.47 (SD 1.66); mean follow-up was 14.05 months (SD 5.25); mean prostatic volume assessed by TRUS was 97.1 ml (SD 18.46) and mean maximum flow Qmax was.6.03 ml/sec (SD 2.37). Mean operative time was 66.34 mn (SD 12.31); mean blood lost was 250 ml (SD 86.82). No patient required transfusions or conversion to open surgery. Mean resected tissue weight was 68.2 gr (SD 15.46) and mean catheterization time was 3.17 days (SD 1.01). Prolonged bladder catheterization was necessary for two patients with mandatory anticoagulation. The mean hospital stay was 4.3 days (SD 1.27). Post operative mean maximum flow Qmax was 26.35 ml/sec (SD 5.87). We found 4 PIN high grade and no invasive prostate carcinoma.ConclusionsIn the hands of an experienced laparoscopic team, FALRP for large benign prostatic hyperplasia is a feasible, reproducible alternative approach to open surgery. It is safe, with minimal intraoperative haemorrhage and post-operative complications, and a shorter convalescence period than open surgery. We believe that FALRP should be part of the armamentarium of any experienced laparoscopic urological surgeon.