Laparoscopic Prostatectomy Intra- and Extraperitoneal Techniques

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George S. Ferzli

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Laparoscopic Prostatectomy Intra- and Extraperitoneal Techniques George Ferzli, MD, FACS Robert Cacchione, MD; Paul Sayad, MD Department of Laparoscopic Surgery Staten Island University Hospital

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Methods of Treating Localized Prostate Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evolution of Laparoscopic Surgery for Prostate Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object]

Anatomy of the Prostate ,[object Object],[object Object],[object Object],[object Object],[object Object]

Prostatectomy: Analogy to Fundoplication esophageal tumor - prostate stomach - bladder esophagus - urethra vagus – neurovasc. bundle

Placement of Trocars ,[object Object],[object Object]

Placement of Trocars (Totally Extraperitoneal Technique)

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Step 1: Transperitoneal Access to Seminal Vesicles ,[object Object],[object Object]

Step 2: Dissection of the Prostatorectal Space ,[object Object],[object Object],[object Object]

Step 2: Lateral Dissection of Rectum vas deferens neurovascular bundle seminal vesicle urethra pubic bone ureter bladder rectum prostate dorsal vein

Step 3: Dissection of the Anterior Pubic Space ,[object Object],[object Object],[object Object],[object Object]

Step 3: Dissection of the Anterior Pubic Space

Step 3: Section of Urethra at Prostatic Apex

Step 4: Mobilization of the Prostate ,[object Object],[object Object],[object Object]

Step 4: Sectioning of Anterior Bladder Neck

Laparoscopic Prostatectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Results of Laparoscopic Prostatectomy Schuessler. Urol. 50:854-57, 1997.

Results of Laparoscopic Prostatectomy Raboy, Albert, Ferzli. Surg Endosc. 12:1264-67, 1998.

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Results of Laparoscopic Prostatectomy Guillonneau. J Urol 163:418-22, 2000.

Results of Laparoscopic Prostatectomy Abbou. Urol. 55:630-633, 2000.

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LAPAROSCOPIC INGUINAL HERNIA REPAIR- OPERATIVE SURGERY #surgicaleducator #operativesurgery #laparascopicinguinalherniarepair #usmle #babysurgeon #surgicaltutor Dear viewers, • Greetings from “Surgical Educator” • Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries. • I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and open and Laparoscopic Cholecystectomy and Open inguinal hernia repair • In this video today, I have discussed Laparoscopic Inguinal Hernia Repair- both TAPP and TEP approaches. • However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery. • Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful. • This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links: • surgicaleducator.blogspot.com • youtube.com/c/surgicaleducator • Thank you for watching the videos.

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Healing Hands Clinic is a unique and speciality clinic for constipation,piles, hernia & prevention of Lifetstyle diseases. Apart from its heart of the city location, expert consultation, state of the art technology and well qualified staff are few of its assets. It is the first clinic in the city to deliver facility of Defecography for constipation. Our focus, dedication and inner feeling of curing or treating the patients with care have given us many satisfied patients.

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The surgical treatment of an injury or defect within the urethra's walls is known as urethroplasty. The three most frequent factors leading to urethral damage that needs to be repaired are trauma, iatrogenic injury, and infections. The gold standard treatment for urethral strictures is urethroplasty, which has a lower recurrence rate than dilatations and urethrotomies. Although recurrence rates are higher for this challenging treatment group, it is likely the only effective treatment option for chronic and severe strictures. Urethroplasty is not regarded as a small procedure, taking three to eight hours on average in the operating room. Between 20% and 30% of urethroplasty patients may benefit from the ease of going under the knife for a shorter period of time and going home the same day. On average, hospital stays last two to three days. Seven to ten days may be needed for hospitalization for more complicated surgeries. Fewer than ten percent of patients experience significant complications after urethroplasty, while complications, particularly recurrences, are more frequent in long and complex strictures.

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