Publications (23)41.73 Total impact
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Article: Evaluation of erectile function after laparoscopic radical prostatectomy in a single center.
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ABSTRACT: To evaluate erectile function among men who had undergone laparoscopic radical prostatectomy and received postoperative medical therapy for erectile dysfunction. We performed a prospective study in men who underwent laparoscopic radical prostatectomy between September 2003 and November 2005 at our center and who received penile rehabilitation after surgery. All patients had antegrade interfascial dissection. They received 10 mg tadalafil on the fifth postoperative day and continued to receive it every other day, regardless of erectile function. Intracavernous injection of alprostadil was initiated at 3 or 6 months depending on response to treatment with tadalafil. Follow up evaluations were done at 3, 6, 12, 18 and 24 months. Oncologic and functional outcomes and compliance were assessed. Patients filled in International Index of Erectile Function-5 (IIEF-5) questionnaires. Of 1078 men who underwent laparoscopic radical prostatectomy during this time, 586 patients met inclusion criteria, complied with the study medication, and had complete data for 24 months. The patients had a median preoperative baseline IIEF-5 score of 22. A total of 150 patients (26%) underwent unilateral nerve-sparing surgery, while 436 patients (74%) had bilateral nerve-sparing surgery. At 24 months, 35% of patients who underwent unilateral nerve-sparing surgery and 68% of patients who underwent bilateral nerve-sparing surgery reported having sufficient erectile function for intercourse without using intracavernous injection of alprostadil. At 24 months after surgery, the median IIEF-5 score was 13 (1-25) for the whole cohort, 5 (1-25) for patients who had undergone unilateral nerve-sparing surgery, and 15 (1-25) for patients who had undergone bilateral nerve-sparing surgery. The findings suggest that adequate patient selection and postoperative medical intervention allows the preservation or recovery of erectile function after laparoscopic radical prostatectomy. Inaccurate selection of patients and postoperative assessment might explain inferior erectile function results following this surgery.The Canadian Journal of Urology 08/2012; 19(4):6328-35. · 0.64 Impact Factor -
Article: Oncologic Outcomes After Laparoscopic Partial Nephrectomy: Mid-Term Results.
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ABSTRACT: Abstract Introduction: To describe the oncologic outcomes of renal cell carcinoma (RCC) diagnosed in patients and submitted to laparoscopic partial nephrectomy (LPN) in a laparoscopic referral center. Patients and methods: We retrospectively analyzed data of 150 consecutive patients with small renal masses and treated with LPN between 2000 and 2010 at a laparoscopic referral center. Pathologic RCC was diagnosed in 137 patients and were included in the oncologic outcome analysis. Kaplan-Meyer methods were used to estimate the probability of disease recurrence and cancer-specific survival. Results: Median follow-up for patients without recurrence was 38 months (interquartile range [IQR] 19-70). The majority of the patients (88%) were found to have pT1a disease at the final pathology report; eight patients (6%) were classified as pT3a. The median tumor size was 25 mm (IQR 20-32). Clear cell type histology was found in 97 patients (66%); most of the patients had Fuhrman grade 2 (72%) or 3 (21%). The 2- and 5-year recurrence-free survival rates were 98% and 95%, respectively. The positive surgical margin was found in 1.4% of the patients. The 2-year and 5-year CSS rates were 99% and 97%, respectively. Kaplan-Meyer methods showed that patients with pT3a were more likely to experience disease recurrence and patients with Fuhrman grade 3 to die of the disease. Conclusions: LPN seems to provide excellent cancer control rates and to be an oncologically feasible and safe option for treating patients with small renal masses. Recurrence and death from the disease are extremely uncommon and mostly related to a higher pathologic stage or Fuhrman grade, but not positive surgical margins.Journal of endourology / Endourological Society 07/2012; · 1.75 Impact Factor -
Chapter: Laparoscopic Simple Prostatectomy
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ABSTRACT: Open prostatectomy is a long accepted method of treating patients with large hyperplasic glands. New therapeutic options have demonstrated efficiency and safety for high volume benign prostatic hyperplasia (BPH). Minimally invasive laparoscopic and endourological treatments have reproduced similar results to open simple prostatectomy with some clinical advantages. Results indicate that laparoscopic simple prostatectomy is a viable option for the surgical treatment of BPH. Available clinical series evidence that in patients with BPH and formal surgical indication, surgery could be safely and properly performed by a laparoscopic technique. Publications concerning laparoscopic simple prostatectomy (LSP) or laparoscopic adenomectomy are mostly based on non experimental studies, such as comparative studies, correlation studies and case reports. The studies underpinning this current chapter were identified through a systematic research using PubMed. There are no randomized or high levels of evidence studies available for LSP. Our objective is to present the available experience in laparoscopic simple prostatectomy which, in our view, is a reproducible, effective procedure for removal of large prostatic adenomas with overall low perioperative morbidity. KeywordsAdenomectomy-Benign prostatic hyperplasia-Extraperitoneal approach-Laparoscopy-Laparoscopic simple prostatectomy-Minimally invasive surgery06/2011: pages 111-120; -
Article: Comparison of the rate, location and size of positive surgical margins after laparoscopic and robot-assisted laparoscopic radical prostatectomy.
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ABSTRACT: • To review and compare the rate, location and size of positive surgical margins (PSMs) after pure laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP). • The study comprised 200 patients who underwent RALP and 200 patients who underwent LRP up to January 2008. • We compared patient age, body mass index, preoperative prostate-specific antigen (PSA), preoperative stage and grade, prostate size, pathological stage and grade and neurovascular bundle preservation, as well as PSM rate, size and location. • Continuous and categorical data were compared using Student's t-test and Pearson's chi-squared test. • Multivariate regression analyses were used to identify preoperative and intraoperative predictors of PSMs. • Although the PSM rate was similar between the two groups (LRP: 12% vs RALP: 13.5%; P = 0.76), location and size were not. PSMs after LRP were mostly at the apex (58.3%; P = 0.038), while most PSMs after RALP were posterolateral ([PL] 48%; P = 0.046). • In addition, the median margin size after RALP was significantly smaller than after LRP (RALP: 2 mm vs LRP: 3.5 mm; P = 0.041). • In univariate and multivariate analyses, tumour-node-metastasis (TNM) stage and preoperative PSA were the only independent preoperative predictors of PSMs (P = 0.044 and P = 0.01, respectively). • The PSM risk is dependent on TNM stage and preoperative PSA and not the surgical technique, when comparing LRP with RALP.BJU International 03/2011; 108(7):1174-8. · 2.84 Impact Factor -
Article: Natural orifice transendoluminal surgery and laparoendoscopic single-site surgery: the future of laparoscopic radical prostatectomy.
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ABSTRACT: Techniques for minimally invasive radical prostatectomy (RP) have been carefully reviewed by surgical teams worldwide in order to identify possible weaknesses and facilitate further improvement in their overall performance. The initial plan of action has been to carefully study the best-practice techniques for open RP in order to reproduce and standardize performance from the laparoscopic perspective. Similar to open surgery, the learning curve of minimally invasive RP has been well documented in terms of objective evaluation of outcomes for cancer control and functional results. Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have recently gained momentum as feasible techniques for minimal access urological surgery. NOTES-LESS drastically limit the surgeon's ability to choose the site of entry for operative instruments; therefore, the advantages of NOTES-LESS are gained with the understanding that the surgical procedure is more technically challenging. There are several key elements in RP techniques (in particular, dorsal vein control, apex exposure and cavernosal nerve sparing) that can have significant implications on oncologic and functional results. These steps are hard to perform in a limited working field. LESS radical prostatectomy can clearly be facilitated by using robotic technology.Future Oncology 03/2011; 7(3):427-34. · 3.16 Impact Factor -
Article: The York Mason operation.
BJU International 08/2010; 106(3):436-47. · 2.84 Impact Factor -
Article: Laparoscopic radical prostatectomy is feasible and effective in 'fit' senior men with localized prostate cancer.
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ABSTRACT: OBJECTIVE To assess the effect of age and comorbidity on short-term complications, long-term continence and oncological outcome after laparoscopic radical prostatectomy (LRP) for localized prostate cancer. PATIENTS AND METHODS In all, 2048 consecutive men underwent LRP for localized prostate cancer in one institution. Comorbidity was assessed using the Charlson index. Short-term postoperative complications, transfusion rate, duration of hospital stay, long-term continence and oncological outcome were analysed by age and comorbidity classes. RESULTS Of the 2048 men, 297 were aged ≥ 70 years and 281 had a Charlson index of >0 (mainly diabetes 31%, chronic pulmonary disease 26%, prior other nonmetastatic cancer 16%, prior myocardial infarction 12%). Compared with younger men, senior men had significantly higher pathological stages and tumor grades. Of those 297 men aged ≥ 70 years, 90 (30.3%) developed biochemical relapse, none died from prostate cancer and five (1.7%) died from another cause over a median follow-up of 5 years. The occurrence and severity of short-term postoperative complications were more strongly related to comorbidity than chronological age. Multivariate analysis with stepwise regression confirmed that most important predictors of short-term postoperative complications were a Charlson index of ≥ 2, prostate weight of >80 g, obesity and age of ≥ 70 years. Postoperative continence significantly declined with age (ranging from 87% in men aged <60 years to 67.5% in men aged ≥ 70 years). Predictors of long-term incontinence were age of ≥ 70 years, obesity and need for perioperative transfusion. CONCLUSIONS LRP is feasible and effective in fit senior men (aged ≥ 70 years) with localized prostate cancer, including those at high risk of dying from it.BJU International 03/2010; 106(10):1530-6. · 2.84 Impact Factor -
Article: Robot-assisted laparoscopic cystoprostatectomy with extended pelvic lymphadenectomy, extracorporeal enterocystoplasty, and intracorporeal enterourethral anastomosis: initial Montsouris experience.
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ABSTRACT: Radical cystectomy is the gold standard for management of invasive and recurrent high-grade superficial bladder cancer. We present our initial experience with robot-assisted laparoscopic cystoprostatectomy (RALCP) with extended pelvic lymphadenectomy (epLAD) and intracorporeal enterourethral anastomosis (IEUA). A video demonstrating our technique is available online at www.liebertonline.com/end. Between April 2008 and March 2009, nine patients underwent RALCP with epLAD and IEUA at our institution. Operative technique, as described in detail (with video), was assessed for feasibility. A video demonstrating this technique is available online at www.liebertonline.com/end. Preoperative patient characteristics, operative data, as well as perioperative and pathologic outcomes were analyzed. All data were collected prospectively. Median total operative time was 270 minutes (range 210-330): 60 minutes, bilateral epLAD; 90 minutes, RALCP; 60 minutes, open enterocystoplasty; 60 minutes (range 45-90), IEUA. Median blood loss was 400 mL (range 200-900 mL). All surgical margins were negative. Median number of lymph nodes removed was 11 (range 4-21). Postoperative complications were noted in three patients and included urinoma (n = 1), pyelonephritis (n = 1), and hematoma (n = 1). RALCP is feasible and can be performed safely and effectively with acceptable operative, pathologic, and short-term clinical outcomes. More experience with longer follow-up is necessary to further assess clinical and oncologic outcomes of robotic assisted laparoscopic cystectomy for treatment of bladder cancer.Journal of endourology / Endourological Society 03/2010; 24(3):409-13. · 1.75 Impact Factor -
Article: Comprehensive surgical and chemotherapy treatment for invasive bladder cancer.
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ABSTRACT: The treatment of transitional cell bladder cancer with muscular invasion remains difficult, due to the numerous patterns of biological behaviour of the disease. There is controversy regarding the application of systemic therapy in invasive bladder carcinoma and the ideal time for the indication of perioperative chemotherapy. This is an overview of systemic therapy in invasive bladder cancer. Using MEDLINE, we reviewed relevant English and Spanish literature published during the last five years, with "chemotherapy in bladder cancer" as keywords. We selected randomised trials, meta-analyses and clinical trials. We obtained 241 articles, 31 of which referred to neoadjuvant and adjuvant chemotherapy in invasive bladder cancer. We classified the articles into three different groups: neoadjuvant, adjuvant and neoadjuvant plus chemotherapy. This information is shown in the tables within the text. A multidisciplinary approach to the treatment of invasive bladder cancer is essential to guarantee adequate oncological control. Detailed evaluation and proper selection of each patient is fundamental in determining the best moment to start chemotherapy.Actas urologicas españolas 11/2009; 33(10):1062-8. · 0.46 Impact Factor -
Article: Postchemotherapy laparoscopic retroperitoneal lymph node dissection in nonseminomatous germ-cell tumor.
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ABSTRACT: Postchemotherapy retroperitoneal lymph node dissection (RPLND) remains essential in the management of metastatic testicular carcinoma and represents a surgical challenge. We determined to assess the feasibility and complications of laparoscopic RPLND in patients who were treated with induction chemotherapy for testis cancer. We performed a retrospective analysis of data that was prospectively recorded from 26 patients who underwent laparoscopic RPLND postplatinum-based chemotherapy between 2000 and 2006. The surgical technique consisted of excision of the residual mass plus unilateral template dissection. A transperitoneal technique was used in 24 patients, and an extraperitoneal approach was used in 2 patients. Operative details, perioperative morbidity data, and histologic findings were assessed for the study. Primary pathologic evaluation of the testis tumor revealed pure embryonal carcinoma in 4 patients, teratocarcinoma in 1 patient, and mixed nonseminomatous germ-cell tumors in 21 patients. All patients had residual disease in the retroperitoneum on a preoperative CT scan, with a median size of 3.4 cm (range 2-6 cm). Procedures in three (11.5%) patients were converted to open surgery. Median operative time was 183 minutes (range 120-260 min). Median estimated blood loss was 400 mL (range 100-600 mL), and blood transfusion was necessary in one patient. Median hospital stay was 5 days (range 2-6 d). Median number of lymph nodes obtained on final histologic examination was 7 (range 4-13). Perioperative complications included eight lymphovascular and one intestinal. At a mean follow-up of 27 months (range 14-36 mos), no recurrences have been observed and no patient was lost to follow-up. Postchemotherapy laparoscopic RPLND is technically feasible. The most frequent complications and causes of conversion are lymphovascular.Journal of endourology / Endourological Society 05/2009; 23(4):645-50. · 1.75 Impact Factor -
Article: A transition to laparoendoscopic single-site surgery (LESS) radical prostatectomy: human cadaver experimental and initial clinical experience.
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ABSTRACT: Laparoendoscopic single-site surgery (LESS) represents a novel approach to abdominal surgery. Several applications have already been described. Drawbacks include limited range of motion and need for articulated instruments. Robotic technology could overcome such technical difficulties. We report our experience with LESS radical prostatectomy (LESS-RP) in a cadaver and LESS robot-assisted radical prostatectomy (LESS-RARP) in a human patient. Standard laparoscopic instruments (SLI) and articulated laparoscopic instruments were used in the cadaveric LESS-RP. The da Vinci system was used in the LESS-RARP. Both procedures reproduced standard extraperitoneal laparoscopic prostatectomy as performed at Institut Montsouris. Control of the dorsal venous complex (DVC) and urethrovesical anastomosis (UVA) were key elements evaluated for feasibility. Cadaveric model: Total operative time (TOT) was 160 minutes, with 5 minutes for the DVC (one stitch) and 35 minutes for the UVA (six stitches). Although articulated instruments were helpful in the operation, SLI remained essential for the procedure. Clinical experience: LESS-RARP was performed for T(1c) prostate cancer. TOT was 150 minutes, including 5 minutes for the DVC (one figure-of-eight stitch) and 30 minutes for the UVA (six interrupted stitches). Blood loss was 500 mL. Bilateral neurovascular preservation was performed, and results of final pathologic examination showed negative surgical margins. The human cadaver is an adequate model for LESS-RP, and LESS-RARP is feasible to be performed in the clinical arena. The synergy of robotic technology and LESS represents a new generation of surgery.Journal of endourology / Endourological Society 02/2009; 23(1):135-40. · 1.75 Impact Factor -
Article: Modified York-Mason technique for repair of iatrogenic rectourinary fistula: the montsouris experience.
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ABSTRACT: Rectourinary fistula is a devastating complication of rectal and genitourinary surgery. Spontaneous closure is rarely successful and failure in conservative management calls for surgical intervention. We present our experience with rectourinary fistula repair using a modified York-Mason technique. We retrospectively reviewed the medical records of all 12 patients who underwent modified York-Mason repair at our institution between 1998 and 2008. Rectourinary fistula developed in 10 patients after radical prostatectomy and in 2 following high intensity focused ultrasound. Six patients were initially treated with fecal diversion. Our approach begins with a transanal incision at the 2 o'clock position representing a modification of the classically described midline incision extending from the coccyx to the anal verge. Key aspects of the York-Mason procedure are maintained. However, we do not close the urethra after fistula excision, and instead perform a multilayer, nonoverlapping closure of the anterior rectal wall only. With a median followup of 22 months we observed the complete resolution of rectourinary fistula in all 12 patients. Three patients required multiple York-Mason procedures to achieve resolution of symptoms. All patients reported intact fecal continence. Median operative time and estimated blood loss were 63 minutes and 100 ml, respectively. Median hospital stay was 4 days. Our modified York-Mason technique is safe and effective for the repair of small, iatrogenic rectourinary fistula. We report 75%, 92% and 100% rectourinary fistula resolution after 1, 2 and 3 York-Mason procedures, respectively, with 100% fecal continence. This technique can be performed multiple times without a significant increase in operative time, estimated blood loss or fecal incontinence.The Journal of urology 02/2009; 181(3):1178-83. · 4.02 Impact Factor -
Article: Role of robotics for prostate cancer.
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ABSTRACT: To describe how robotics became involved in prostate cancer as well as to highlight the most important developments in robotic prostate cancer treatment during the last year. Refinements in technique during robotic-assisted laparoscopic prostatectomy have improved the early return of continence postoperatively. Mean positive surgical margin rates were lowest for robotic-assisted laparoscopic prostatectomy as compared to pure laparoscopic or open radical prostatectomy series. Sexual potency rates were similar among all surgical treatments of prostate cancer. As the implementation of robotic technologies to treat prostate cancer continues to grow, randomized controlled trials will eventually provide a better comparison of results. The role of robotics in prostate cancer treatment is established, and continued technical advancements will ultimately improve patient outcomes.Current opinion in urology 02/2009; 19(1):65-8. · 2.50 Impact Factor -
Chapter: The French Experience: A Comparison of the Perioperative Outcomes of Laparoscopic and Robot-Assisted Radical Prostatectomy at Montsouris
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ABSTRACT: The robotic-assisted laparoscopic prostatectomy (RALP) has gained rapid acceptance in the urological community due to its documented advantages over standard laparoscopy radical prostatectomy (LRP)1,2 and open prostatectomy.3–5 This advantage has been most appreciated with regards to the learning curve due to enhanced three-dimensional visualization and instruments that allow six degrees of freedom of motion.6 These benefits to the surgeon must, however, translate to improved overall outcomes to justify the increased economic burden placed by the robot.7–9 In this chapter, we will review the current literature for the peri-operative morbidities of RALP. Due to our extensive experience with pure LRP at Montsouris,10,11 the minimally invasive standard to which the RALP must be compared, we will reference the current literature and our own series of both RALP and LRP to make the necessary comparisons for this developing technology.08/2008: pages 101-105; -
Article: Robot-assisted versus pure laparoscopic radical prostatectomy.
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ABSTRACT: The aim of this study is to report the relative advantages and disadvantages of the radical prostatectomy with a laparoscopic (LRP) and a robotic (RALP) approach. A medline search was performed. Published data regarding perioperative parameters, complications, oncological results, functional results were analyzed. Shorter learning curves have been reported with the RALP. Intra-operative and post-operative outcomes appear to be comparable between the two approaches. The average time for LRP is 234 min (151-453) versus 182 min (141-250) for RALP. Estimated blood loss for the LRP averages 482 ml (185-850) versus 234 ml (75-500) for the RALP. Complication rates in single institution studies are similar. Long-term outcomes data on PSA progression is not yet available for LRP or RALP due to their relatively short existence. RALP appears to offer a significant benefit to the laparoscopically naïve surgeon with respect to learning curve when compared to LRP. This, however, comes at an increased cost. Intra-operative and post-operative outcomes appear to be similar. Longer follow-up data is necessary to compare oncological and functional outcomes.World Journal of Urology 07/2006; 24(2):171-9. · 2.41 Impact Factor -
Article: Benefits of laparoscopic prostate-sparing radical cystectomy.
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ABSTRACT: PURPOSE: Prostate-sparing radical cystectomy has been described in the literature and has proven to be a promising procedure owing to the continence and erectile function results without necessarily compromising the oncologic outcome in selected patients. TECHNIQUE POINTS: A transperitoneal approach is used. Lymph node dissection is performed with frozen section, and then the ureters are ligated and biopsied. The seminal vesicles are dissected, followed by complete mobilization of the bladder. Incision of the bladder neck is performed, followed by simple prostatectomy. Finally, bowel reconstruction is carried out via a small infra-umbilical incision that also permits the extraction of the surgical specimen and the anastomosis of neobladder to the prostate capsule. A total of 25 patients have undergone this procedure, with average surgical times of 285 min and blood loss of 640 ml. The complications encountered included: one bowel incarceration, one urinary leak, one lymphocele and one port hernia. At median 9 months follow-up, no patient presented with daytime incontinence, although seven complained of nocturia. A total of 20 patients maintained their preoperative sexual potency, and four reported a postoperative decrease in their erectile function. CONCLUSIONS: Laparoscopic prostate-sparing radical cystectomy appears to be oncologically safe, reproducible and has promising functional benefits. The authors believe this procedure presents a good option in very select patients.Expert Review of Anti-infective Therapy 02/2006; 6(1):21-6. · 2.65 Impact Factor -
Article: Laparoscopic prostate-sparing radical cystectomy: the Montsouris technique and preliminary results.
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ABSTRACT: Prostate-sparing radical cystectomy has been described in the literature and has proven to be a promising procedure because of the continence and erectile function results which does not necessarily compromise the oncologic outcome in properly selected patients. We report our preliminary results with this technique performed laparoscopically. A total of 25 patients with an average age of 60 years have undergone this procedure. Through a transperitoneal approach, lymph-node dissection is done with frozen-section examination, and the ureters are ligated and biopsied. The seminal vesicles are dissected, followed by complete mobilization of the bladder. Next the bladder neck is incised followed by the bladder-pedicle dissection. A simple prostatectomy can be performed if required. Finally, the neobladder is reconstructed via a small infraumbilical incision that also permits extraction of the surgical specimen. The neobladder is anastomosed to the prostate capsule. The average surgical time was 285 minutes and the mean blood loss 640 mL. The complications encountered (4) were: one case each of bowel incarceration, urinary leak, lymphocele, and port-site hernia. All but one of the patients are alive at 9-month follow-up, with the one patient dying of cancer progression. No patient presented with daytime incontinence, although seven reported nocturia. There were 20 patients who maintained their preoperative sexual potency, and four described a decrease in erectile function postoperatively. We have been performing laparoscopic prostate-sparing radical cystectomy for more than 2 years and have found it oncologically safe and reproducible with promising functional benefits. It presents a good option for properly selected patients.Journal of Endourology 05/2005; 19(3):424-8. · 1.85 Impact Factor -
Article: Laparoscopic sacral colpopexy approach for genito-urinary prolapse: experience with 363 cases.
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ABSTRACT: To evaluate the surgical outcome, complications and benefits of laparoscopic double promonto-fixation for patients with pelvic prolapse. Women with genito-urinary prolapse underwent a transperitoneal placement of a 100% polyester mesh on the anterior vaginal wall and a posterior mesh on the levator ani muscle. Both of these were anchored to the sacral promontory. A TVT was placed simultaneously in patients who had concurrent stress urinary incontinence. A total of 363 patients were operated upon between 1996 and 2002. Their mean age was 63 (range 35-78), average follow-up was 14.6 months, the mean operating time was 97 minutes. There were 8 conversions due to anesthetic or surgical difficulties. Follow up was done by a postal questionnaire and physical examination at 6 months and then yearly. 96% were satisfied with the results of their operation and no patients complained of sexual dysfunction. There was a 4% recurrence rate of prolapse, 3 vaginal erosions, 2 urinary retentions that required TVT section, 1 bowel incarcerations, 1 spondylitis and 2 mesh infection. Laparoscopic promonto-fixation is feasible and highly effective technique that offers good long-term results with complication rates similar to open surgery, with the added benefits of minimally invasive surgery.European Urology 03/2005; 47(2):230-6. · 8.49 Impact Factor -
Article: Laparoscopic radical prostatectomy: the new gold standard?
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ABSTRACT: Radical prostatectomy is the reference treatment for localized prostate cancer. The minimal invasive approach is gaining support in a large number of centers around the world because the laparoscopic approach seems to maintain the oncological control of open surgery with added benefits for the patient. In this paper, the main aspects of the different laparoscopic approaches, their benefits, difficulties, complications, and results are described and compared with the open radical prostatectomy. A critical review of the literature on radical prostatectomy comparing the open and laparoscopic techniques and the differences between each approach was done.Current Urology Reports 05/2004; 5(2):108-14. -
Article: Re: Initial complete laparoendoscopic single-site surgery robotic assisted radical prostatectomy(LESS-RARP).
International braz j urol: official journal of the Brazilian Society of Urology 35(1):92-3.
Top co-authors
Top Journals
Institutions
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2009–2012
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Université Paris Descartes
Paris, Ile-de-France, France
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2004–2009
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Institute Mutualiste Montsouris
Paris, Ile-de-France, France
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2005–2006
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Université René Descartes - Paris 5
Paris, Ile-de-France, France
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