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IMPOTENCE: Laparoscopic Radical Prostatectomy: The Video
733
VIDEO REVIEWS
VIDEO REVIEWS CANCER/BENIGN PROSTATIC HYPERPLASIA/IMPOTENCE Laparoscopic Radical Prostatectomy: The Heilbronn Technique J. RASSWEILER, O. SEEMANN, M. EL QUARAN, L. SENTKER AND C. STOCK, Heilbronn, Germany, 13 minutes, 2000 Vesicourethral Reconstruction During Laparoscopic Radical Prostatectomy C.-C. ABBOU, A. HOZNEK, L. SALOMON, P. ANTIPHON, M.-R. BEN SLAMA, F. SAINT AND D. CHOPIN, Cre´teil, France, 14 minutes, 2000 The Extraperitoneal Laparoscopic Radical Prostatectomy: A New Approach R. BOLLENS, V. BOSSCHE, T. ROUMEGERE, A. DAMOUN, A. R. ZLOTTA 2000
AND
C. C. SCHULMAN, Brussels, Belgium,
These 3 videotapes describe developing techniques of radical prostatectomy and clearly show the differences of those used in early clinical trials until such time when long-term results established more standard approaches. The video by Bossche et al describes a completely retroperitoneal approach, whereas the other 2 videos describe intra-abdominal approaches. Most authors use a continuous approach. The postoperative catheter time is shorter in some of these studies (4 to 14 days) compared to the usual 14 to 21 days for open radical prostatectomy. The ultimate questions have not been yet answered. Is the continence rate better? Is the potency rate better? We will need a minimum of 2 to 3 years of followup for these answers. M. Eshghi, M.D. Penile Disassembly Technique to Surgical Treatment of Peyronie’s Disease S. V. PEROVIC, M. L. J. DJORDJEVIC
AND
N. G. DJAKOVIC, Belgrade, Yugoslavia, 19 minutes, 2000
This videotape describes an aggressive technique of dissecting the penile structure for correction of Peyronie’s disease. The penis is completely degloved, glans cap is lifted and neurovascular bundle is dissected. After incision of plaques, the gaps are filled with penile skin graft. The authors claim this procedure does not affect potency or sensory perception of the penis. This procedure has been performed in children with equal success. As mentioned earlier this dissection is extensive and, as the title suggests, it is a true disassembly. This method should not be attempted by a urologist who occasionally performs such a procedure and most pediatric urologists will not attempt this degree of dissection. M. Eshghi, M.D. Laparoscopic Radical Prostatectomy: The Video I. S. GILL, C. ZIPPE, S. SAVAGE
AND
G. T. SUNG, Cleveland, Ohio, 12 minutes, 2000
This beautifully done video won second prize at the 95th annual meeting of the American Urological Association in Atlanta. The technically demanding procedure of laparoscopic radical nephrectomy is broken down into 10 essential steps: 1) 5-port transperitoneal approach, 2) mobilization of seminal vesicles bilaterally, 3) incision of Denonvillier’s fascia and development of the tissue plane between the rectum and prostate, 4) exposure of the space of Retzius, 5) incision of endopelvic fascia, 6) dorsal vein ligation, 7) transection of the bladder neck, 8) control of lateral pedicles of the prostate, 9) urethral transection at the apex of the prostate and 10) urethrovesical anastomosis. Each step is compared visually with the open procedure. Perhaps the finest compliment that can be given is that the operation looks easy! Followup is limited but the 1-day hospital stay and minimal blood loss accompanied by superb visualization make the procedure appealing. Anyone contemplating adding this procedure to his or her practice would benefit from this illustration of the technique. Philip Hanno, M.D. STONE DISEASE/LAPAROSCOPY Contralateral Ureterolithotomy S.-B. KULKARNI
AND
D. V. KIRPEKAR, Pune, India, 9 minutes, 2000
This open technique for removal of bilateral ureteral stones with 1 incision has been performed in 4 patients. After performing ipsilateral ureterolithotomy, dissection is carried over the vessels across to the other ureter and palpation of an usually large stone. Ureterotomy is performed followed by placement of a Double-J* stent and closure of the ureter. This situation is clearly not common and neither is this approach due to availability of endoscopic techniques and shock wave lithotripsy at most centers. The significance of this videotape is in demonstrating the extension of dissection to the contralateral side to avoid multiple incisions. M. Eshghi, M.D. * Medical Engineering Corp., New York, New York.
VIDEO REVIEWS
VIDEO REVIEWS CANCER/BENIGN PROSTATIC HYPERPLASIA/IMPOTENCE Laparoscopic Radical Prostatectomy: The Heilbronn Technique J. RASSWEILER, O. SEEMANN, M. EL QUARAN, L. SENTKER AND C. STOCK, Heilbronn, Germany, 13 minutes, 2000 Vesicourethral Reconstruction During Laparoscopic Radical Prostatectomy C.-C. ABBOU, A. HOZNEK, L. SALOMON, P. ANTIPHON, M.-R. BEN SLAMA, F. SAINT AND D. CHOPIN, Cre´teil, France, 14 minutes, 2000 The Extraperitoneal Laparoscopic Radical Prostatectomy: A New Approach R. BOLLENS, V. BOSSCHE, T. ROUMEGERE, A. DAMOUN, A. R. ZLOTTA 2000
AND
C. C. SCHULMAN, Brussels, Belgium,
These 3 videotapes describe developing techniques of radical prostatectomy and clearly show the differences of those used in early clinical trials until such time when long-term results established more standard approaches. The video by Bossche et al describes a completely retroperitoneal approach, whereas the other 2 videos describe intra-abdominal approaches. Most authors use a continuous approach. The postoperative catheter time is shorter in some of these studies (4 to 14 days) compared to the usual 14 to 21 days for open radical prostatectomy. The ultimate questions have not been yet answered. Is the continence rate better? Is the potency rate better? We will need a minimum of 2 to 3 years of followup for these answers. M. Eshghi, M.D. Penile Disassembly Technique to Surgical Treatment of Peyronie’s Disease S. V. PEROVIC, M. L. J. DJORDJEVIC
AND
N. G. DJAKOVIC, Belgrade, Yugoslavia, 19 minutes, 2000
This videotape describes an aggressive technique of dissecting the penile structure for correction of Peyronie’s disease. The penis is completely degloved, glans cap is lifted and neurovascular bundle is dissected. After incision of plaques, the gaps are filled with penile skin graft. The authors claim this procedure does not affect potency or sensory perception of the penis. This procedure has been performed in children with equal success. As mentioned earlier this dissection is extensive and, as the title suggests, it is a true disassembly. This method should not be attempted by a urologist who occasionally performs such a procedure and most pediatric urologists will not attempt this degree of dissection. M. Eshghi, M.D. Laparoscopic Radical Prostatectomy: The Video I. S. GILL, C. ZIPPE, S. SAVAGE
AND
G. T. SUNG, Cleveland, Ohio, 12 minutes, 2000
This beautifully done video won second prize at the 95th annual meeting of the American Urological Association in Atlanta. The technically demanding procedure of laparoscopic radical nephrectomy is broken down into 10 essential steps: 1) 5-port transperitoneal approach, 2) mobilization of seminal vesicles bilaterally, 3) incision of Denonvillier’s fascia and development of the tissue plane between the rectum and prostate, 4) exposure of the space of Retzius, 5) incision of endopelvic fascia, 6) dorsal vein ligation, 7) transection of the bladder neck, 8) control of lateral pedicles of the prostate, 9) urethral transection at the apex of the prostate and 10) urethrovesical anastomosis. Each step is compared visually with the open procedure. Perhaps the finest compliment that can be given is that the operation looks easy! Followup is limited but the 1-day hospital stay and minimal blood loss accompanied by superb visualization make the procedure appealing. Anyone contemplating adding this procedure to his or her practice would benefit from this illustration of the technique. Philip Hanno, M.D. STONE DISEASE/LAPAROSCOPY Contralateral Ureterolithotomy S.-B. KULKARNI
AND
D. V. KIRPEKAR, Pune, India, 9 minutes, 2000
This open technique for removal of bilateral ureteral stones with 1 incision has been performed in 4 patients. After performing ipsilateral ureterolithotomy, dissection is carried over the vessels across to the other ureter and palpation of an usually large stone. Ureterotomy is performed followed by placement of a Double-J* stent and closure of the ureter. This situation is clearly not common and neither is this approach due to availability of endoscopic techniques and shock wave lithotripsy at most centers. The significance of this videotape is in demonstrating the extension of dissection to the contralateral side to avoid multiple incisions. M. Eshghi, M.D. * Medical Engineering Corp., New York, New York.