Evaluation of the Outcome of Laparoscopic Radical Prostatectomy by a Single Surgeon: Experience with an Initial 30 Cases

Objective: We carried out this study to clarify whether operative methods of laparoscopicprostatectomy (LRP) could become a standard therapy. The purpose was to evaluate thetechnical feasibility, oncologic effectiveness and perioperative and postoperativemorbidity of LRP performed by a general urologist.Patients and Methods: Between June 2004 and May 2006, 30patients with clinically localized prostate cancer consecutively underwent LRP by a singlesurgeon. Oncologic data were assessed by histopathological examination and bypostoperative prostate-specific antigen (PSA) levels.Results: Complete laparoscopic removal of theprostate and seminal vesicles was achieved in all 30 patients. The average operation timewas 250.9 min (range, 168 to 394 min). The total positive surgical margin rate was 20.7%(6 of 29 cases), with a total PSA recurrence rate was 23.3% (7 of 30 cases), but thefrequencies tended to be decreased in the later phase cases. Perioperative complicationswere encountered in 5 patients; four of these patients were in the initial 10 cases. Twoof the 30 cases (6.7%) required a blood transfusion (first case and 11th case). There werethree surgical complications, one ureter injury, one rectal injury and one sigmoid serosalinjury. The catheter duration intervals were reduced in the later cases.Conclusions:From ourexperience with one surgeon, with whom perioperative complications were concentrated inthe initial 10 cases, we conclude that LRP should be performed by experienced surgeonsafter intensive training.