title: Laparoscopic retropubic simple prostatectomy.
abstract: OBJECTIVE
  Open retropubic simple prostatectomy is occasionally performed for symptomatic, large volume benign prostatic hyperplasia. We describe the technique of laparoscopic simple retropubic prostatectomy.
  
  
  METHODS
  Since August 2001 at our 2 institutions laparoscopic simple retropubic prostatectomy has been performed in 17 patients with symptomatic significant prostatomegaly on transrectal ultrasonography (60 gm or greater, mean 93). Essential aspects of our 5 port technique are transverse cystotomy just proximal to the prostatovesical junction, subcapsular plane development, prostatic adenomectomy, prostatic fossa trigonization and prostatic capsule suture repair. Demographic, perioperative and outcome data were recorded.
  
  
  RESULTS
  Mean operative time was 156 minutes (range 85 to 380), blood loss was 516 ml (range 100 to 2,500), hospital stay was 48 hours (range 15 to 110), and Foley catheter duration was 6.3 days (range 3 to 7). Mean specimen weight on pathological examination was 72 gm (range 32 to 120). Five patients (29%) required blood transfusion. Complications occurred in 3 patients (19%), that is intraoperative hemorrhage, catheter clot obstruction and duodenal ulcer bleeding in 1 each. All patients reported complete continence during a followup period of 1 month to 2 years. Considerable improvement from baseline was noted in American Urological Association score (preoperative vs postoperative 24.5 vs 9.9) and the maximum urine flow rate (preoperative vs postoperative 7 vs 22.8 cc per minute).
  
  
  CONCLUSIONS
  Laparoscopic simple retropubic prostatectomy for large benign prostate hyperplasia is feasible. Our initial experience is presented.
authors.affiliation: La Floresta Medical Institute, Caracas, Venezuela.
authors.forename: René
authors.initials: R
authors.lastname: Sotelo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Spaliviero
authors.forename: Alejandro
authors.initials: A
authors.lastname: Garcia-Segui
authors.forename: Waleed
authors.initials: W
authors.lastname: Hasan
authors.forename: John
authors.initials: J
authors.lastname: Novoa
authors.forename: Mihir M
authors.initials: MM
authors.lastname: Desai
authors.forename: Jihad H
authors.initials: JH
authors.lastname: Kaouk
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000601:surgery*