The basic technique for performing minimally invasive radical prostatectomy is the same regardless of the technology used. Candidates for this approach include patients in whom the diagnosis and staging support organ-confined prostate cancer and in whom the appropriate metastatic workup results are negative. The goal of minimally invasive radical prostatectomy is to laparoscopically resect the prostate and its capsule, along with the seminal vesicles. The procedure can be performed either extraperitoneally or, more commonly, transperitoneally. The two most reported techniques for performing minimally invasive radical prostatectomy are robotic (robotic radical prostatectomy) and laparoscopic (laparoscopic radical prostatectomy).
Laparoscopic radical prostatectomy
The laparoscopic approach involves 2-dimensional monitors and conventional laparoscopic instruments (5 or 10 mm) with a 10-mm 0° and/or 30° telescope. The camera may be operated by a one-armed camera holder or by an assistant. The use of a single voice-operated robotic arm has also been described as an adjunct to the laparoscopic approach. A camera-holding device provides stability and prevents camera shake that can result from holding it by hand (ie, by an assistant).
