title: Evolution of endoscopic extraperitoneal radical prostatectomy (EERPE)--technical improvements and development of a nerve-sparing, potency-preserving approach.
abstract: During the last decade, laparoscopy has become a standard technique in the armoury of the urologist due to constant technological advances and refinements. Laparoscopic radical prostatectomy (LRPE), although technically demanding and associated with a considerable learning curve, has become the surgical procedure of choice in selected and specialized urological centers around the globe for patients with clinically localized prostate cancer. However, a major drawback of LRPE is the transperitoneal route of access to the extraperitoneal prostate. The principal disadvantages of LRPE are potential intraperitoneal complications, such as bowel injury, ileus, intraperitoneal bleeding, intraperitoneal urinary leakage, intraperitoneal adhesion formation and concomitant small bowel obstruction. Endoscopic extraperitoneal radical prostatectomy (EERPE) is a further advancement of minimal invasive surgery as it overcomes the limitations of LRPE by the strictly extraperitoneal route of access combining the advantages of minimal invasive surgery with those of an extraperitoneal procedure. Based on our growing experience with this procedure, we have introduced several technical modifications, improvements and refinements including a nerve-sparing, potency-preserving approach (nEERPE) in an effort to further improve this minimally invasive procedure.
authors.affiliation: Department of Urology, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany. stolj@medizin.uni-leipzig.de
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
authors.forename: Michael C
authors.initials: MC
authors.lastname: Truss
authors.forename: Minh
authors.initials: M
authors.lastname: Do
authors.forename: Robert
authors.initials: R
authors.lastname: Rabenalt
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Pfeiffer
authors.forename: Michael
authors.initials: M
authors.lastname: Dunzinger
authors.forename: Bernd
authors.initials: B
authors.lastname: Aedtner
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.forename: Udo
authors.initials: U
authors.lastname: Jonas
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Dorschner
mesh_terms: D000328:Adult; D000368:Aged; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011467:Prostate / Q000294:innervation; D011468:Prostatectomy / Q000379:methods*; D012371:Robotics; D013536:Suture Techniques