CODE: 15.1 - Use of mechanic stapler to achieve hemostatasis of Santorini's venous complex during laparoscopic radical prostatectomy
Article published in Urologia Polska 2006/59/Suplement 1.
Tomasz Borkowski, Daniel Leszczyński, Dariusz Ostapowski, Andrzej Borkowski
- Klinika Urologii AM w Warszawie
- Introduction. Dissection and transsection of dorsal venous complex is an important step in laparoscopic radical prostatectomy. We herein present a technical modification facilitating this maneuver with the application of mechanic suturing device.
- The aim of the study. Feasibility study of mechanic suturing stapler (endo GIA 35mm) function in terms of it's application for dorsal vein complex ligation during laparoscopic radical prostatectomy
- Material and methods. In three following patients who underwent laparoscopic radical prostatectomy an endoscopic gastrointestinal stapler (endo GIA) was used. In the course of operation after exposing of the anterior surface of the prostate, disjointing of endopelvic fascia and dissecton of the apex the endo-GIA stapler has been introduced and placed on the Santorini's complex together with preserved puboprostatic ligaments. When a Beniquet sound was placed in the uretha for it's protection the transsection of venous complex and ligaments could be accomplished and a free access to the urethra was obtained.
- Results Maneuver of transsection of Santorini's plexus has been completed bloodlessly and it lasted approximately 3 minutes. There has not been any additional technical problem encountered. On histopathological examination none of the patients has a positive surgical margins at the apex. We observe gradual return of urinary continence in all patients.
- Conclusions. Application of mechanic stapling device during laparoscopic radical prostatectomy is feasible and may result in reduction of blood loss and operating time.