PTU - Polskie Towarzystwo Urologiczne
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Article published in Urologia Polska 1999/52/2.


Grzegorz Kata, Artur A. Antoniewicz, Andrzej Borówka
Oddział Urologii Centralnego Szpitala Kolejowego w Warszawie
Ordynator Oddziału: prof. dr hab. n. med. A. Borówka


prostate carcinoma lymphadenectomy laparoscopy


20 patients aged 51-75 underwent laparoscopic obturator lymph node
dissection between 1996-1998. All of them with histologically proved prostate
carcinoma (clinical stage T ? 3 No M()) were ±ualified for staging before
radiotherapy. The method of the bilateral access to fossa obturatoria called
"butterfly suture" was performed in 15 patients. The idea of the techni±ue is to
make a suture looking like butterfly at laparoscopy. A PDS suture on rectilinear
needle is introduced into the perineal cavity percutaneously. Afterwards both
of the medial edges of incised peritoneumare protracted. The suture after
crossing is knotted extracorporeally - fraction of the ends of the suture gives
wide opening of both obturator fossas. Lymphatic tissue was removed
completely. The nodes were metastatic in three patients. There were no
intraoperative complications. We observed early postoperative complications
in three patients. The lymphocele occurred in one patient two weeks following
Considering our experience laparoscopy is minimally invasive and safe
method of removal of obturator lymph nodes at patient with prostatic carcinoma
for the staging before radiotherapy or perineal prostatectomy. Laparoscopic
lymphadenectomy is suitable alternative to other more invasive techni±ues.
The "butterfly suture" improves performing procedure.


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