Kazimierz Krajka, Marcin Markuszewski, Dariusz Perkowski, Marcin Matuszewski
- Katedra i Klinika Urologii AM w Gdańsku
- Introduction. Despite enormous progress in minimally invasive treatment of benign prostatic hyperplasia, in cases when prostate exceeds 100 cm3, it is recommended to consider an open operation. Introduction of new surgical technologies into everyday urological practice allows to improve the details of procedure of retropubic adenomectomy proposed by Terence Millin in 1947.
- Objectives. Presentation of technical details of the operation.
- Materials and methods. The film demonstrates the technique of retropubic, transcapsular adenomectomy utilising two kinds of Ligasure clips, harmonic knife and eletctrocoagulation in ,,spray" option. Indications for using of them in adequate phases of the procedure are presented. The time, blood loss and completeness of the treatment are also discussed.
- Results. Adenomectomy according to Millin principles with utilisation of modern technologies is an about one-hour procedure allowing perfect intraoperative control over completeness of prostate resection and hemostasis. It also enables a time of the postoperative hospitalisation to be shortened to 4 days.
- Conclusions. In older patients, burdened with coexisting general health problems and having prostate of more than 100 cm3, with indications for invasive treatment, it is worthwhile to consider an "open" operation as an valuable option. In authors experience best results can be achieved with Millin procedure utilising new technologies as Ligasure, harmonic knife, and modern options of electrocoagulation.