Laparoscopic prostatic adenomectomy

When is it needed?

Laparoscopic prostate adenomectomy is used to surgically treat BPH (benign prostate hyperplasia) in cases of a significantly enlarged prostate. The size limit above which this procedure is performed varies from establishment to establishment, but it is usually around 100 ml.

How is it performed?

In order to perform laparoscopic adenomectomy, we require 4-5 trocars inserted at the bottom part of the abdominal wall. We get extraperitoneal access using a special technique of balloon dilation that forms a space in front of the peritoneum (the inner membrane tissue of the stomach) where the trocars are then inserted. After detaching the fatty tissue from the prostate and the bladder neck, we open the prostatic capsule in order to slice away the prostate adenoma. After placing a post-operative urinary catheter, the prostate capsule is stitched closed, and a drainage tube is placed to monitor and control possible bleeding and/or urine secretion. The endoscopic bag containing the tissue is removed through an extended incision made at the one of the trocar incisions. The remaining trocars are removed, and the incisions are stitched up.

What are the possible complications?

Complications in laparoscopic prostate adenomectomy are rare. The most common possible complication is bleeding that rarely requires a blood transfusion. Approximately less than 1% of laparoscopic prostate adenomectomies require a conversion to the open surgical approach.