Anatomy - sparing laparoscopic radical prostatectomy… is it possible?

The fact is that nerve- and fascial-sparing robot-assisted technique improves functional results of radical prostatectomy.The aim of study: to evaluate feasibility and effectiveness of anatomy-sparing radical prostatectomy performed by conventional laparoscopy.Material and methods: A total of 4025 patients with prostate cancer who underwent conventional lap radical prostatectomy (LRP) between 2010 and 2020 were retrospectively reviewed. After that only cases of anatomy-sparing technique were enrolled. The perioperative parameters of these 714 men were analyzed. Continence was defined by “Pad-test” 1 or none.Results: There were no mortality, intra- and Clavien ≥ III postoperative complications i.q. conversions to open surgery. Average OR time & EBL - 155,3 min & 187,2 ml respectively. Mean time of bladder catheterization - 7,4 d. The frequency of positive surgical margins - 9,7%. Immediate and absolute continence has been reached in 38,2% of cases. In the other 42,3% of patients the “Pad-test” was not more than one. Thus 80,5% of our patients were satisfied with urination after surgery. Conclusions: conventional laparoscopic surgical technique described in this paper is not only feasible effective and safe but also achieve a better functional result.