TY - JOUR
T1 - Natural orifice (NOTES) transurethral sutureless radical prostatectomy with thulium laser support: First patient report
AU - Nagele, Udo
AU - Anastasiadis, Aristotelis G.
AU - Walcher, Ute
AU - Nicklas, Andre P.
AU - Merseburger, Axel S.
AU - Herrmann, Thomas R.W.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/11
Y1 - 2012/11
N2 - Introduction: The aim of this descriptive study was to demonstrate the feasibility and safety of the first true transurethral sutureless radical prostatectomy for prostate cancer in humans using the NOTES technique. Materials and methods: A 77-year-old man with clinically localized bilateral prostate cancer (Gleason 3 + 4 = 7 in 80% of 12 biopsy cores) and a serum PSA level of 2.1 ng/ml underwent our first natural orifice transurethral radical thulium laser prostatectomy within toto organ retrieval via sectio alta. The surgical procedure is described. Results: The procedure was completed successfully. Overall operation time was 312 min; laser time was 46 min with 151 KJ. Postoperative hemoglobin was 9.4 g/dl, and the hematocrit was 28%. A cystogram on the 7th postoperative day showed no signs of extravasation and the transurethral catheter was removed, and a flexible cystoscopy on the 9th day demonstrated a sufficient arbitrarily sphincter closure against irrigation flow. Conclusion: The presented descriptive report demonstrates that natural orifice transurethral radical thulium laser prostatectomy for prostate cancer is feasible and safe. Potential candidates include older patients with low-risk cancers and urinary obstruction. Further prospective reports are necessary to evaluate functional and oncological outcome for this innovative technique.
AB - Introduction: The aim of this descriptive study was to demonstrate the feasibility and safety of the first true transurethral sutureless radical prostatectomy for prostate cancer in humans using the NOTES technique. Materials and methods: A 77-year-old man with clinically localized bilateral prostate cancer (Gleason 3 + 4 = 7 in 80% of 12 biopsy cores) and a serum PSA level of 2.1 ng/ml underwent our first natural orifice transurethral radical thulium laser prostatectomy within toto organ retrieval via sectio alta. The surgical procedure is described. Results: The procedure was completed successfully. Overall operation time was 312 min; laser time was 46 min with 151 KJ. Postoperative hemoglobin was 9.4 g/dl, and the hematocrit was 28%. A cystogram on the 7th postoperative day showed no signs of extravasation and the transurethral catheter was removed, and a flexible cystoscopy on the 9th day demonstrated a sufficient arbitrarily sphincter closure against irrigation flow. Conclusion: The presented descriptive report demonstrates that natural orifice transurethral radical thulium laser prostatectomy for prostate cancer is feasible and safe. Potential candidates include older patients with low-risk cancers and urinary obstruction. Further prospective reports are necessary to evaluate functional and oncological outcome for this innovative technique.
UR - http://www.scopus.com/inward/record.url?scp=84868524308&partnerID=8YFLogxK
U2 - 10.1007/s00345-011-0714-z
DO - 10.1007/s00345-011-0714-z
M3 - Journal articles
C2 - 21739124
AN - SCOPUS:84868524308
VL - 30
SP - 625
EP - 631
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
IS - 5
ER -