Objectives: We describe a simple mono-institutional study to prospectively assess the benefits and complications of the mini-laparotomic incision for radical retropubic prostatectomy with the anatomic approach.
Methods: Radical retropubic prostatectomy with the anatomical approach, as described by Walsh, was performed through a 4 to 8 cm incision. Median operative time, body weight, prostate weight, pathologic stage, incidence of positive surgical margins, urinary continence, the need for post-operative analgesics, peri-operative complications, are the parameters we assessed. Blood losses were calculated with the aid of a specific formula instead of simply recording the suction or weighing the sponges.
Results: 52 patients were consecutively operated on through a mini-laparotomic incision. Median incisional length was 8 cm (range 4 to 8 cm). Median operating time was 116 minutes (105-141), calculated blood loss was 1108.797ml, incidence of positive margins was 14%, urinary continence was observed in 48/50 patients (98%), and there was a complication rate of 4/52 (7.6%).
Conclusion: The results we obtained with the mini-laparotomic incision are comparable to previous reports of the standard incision, also by our group, though with a lower need for postoperative analgesia. They also compare with laparoscopic prostatectomy in the length of time of catheterization and post-operative analgetic consumption.