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Medical Forum / Diseases and Disorders / Prostate Cancer / December 2005Mini-laparotomy Prostatectomy
Any experience here with the mini-laparotomy version of RRP? Paul Johnson 62 years old, excellent health 4+3, 3+3 T1c Never heard of it. What's this? Who does it? Dave Perry > Any experience here with the mini-laparotomy version of RRP? > > Paul Johnson > 62 years old, excellent health > 4+3, 3+3 > T1c Perhaps you're thinking of laparoscopic radical prostatectomy, usually called LRP, as opposed to radical retropubic prostatectomy, usually called RRP. A number of guys here had LRP. If you search the Google archive for this newsgroup for "LRP" you should get some useful hits. Alan > > Any experience here with the mini-laparotomy version of RRP? > > [quoted text clipped - 11 lines] > > Alan From the "Complete Guide to Prostate Cancer" book published this year by the American Cancer Society page 191---an excellent resource I recommend to all: "Mini-Laparotomy Prostatectomy A new modification of the prostectomy that is not yet widely used but deserves special mention is the mini-laparotomy prostatectomy. (Mini-laparotomy should not be confused with -laparoscopic- procedusres.) Advances in surgical anatomy, technique, and new instruments have allowed surgeons to remove the prostate gland through smaller or "mini" incisions. The opening through which the prostate is removed can be a small as 4 inches, half the size of the traditional incision." It lists these advantages: decreased pain and recovery time, less scarring, when performed by experienced surgeons blood transfusions are almost never needed, incontenance is extrememly rare, as with other techniques potency varies by age and stage. This style of RPP is apparently used at University of California, San Francisco Medical Center, one of the nation's highly rated care centers. My care is through Kaiser-Santa Teresa whose urology department follows the best practices lead of UCSF. Paul ... > "Mini-Laparotomy Prostatectomy > > A new modification of the prostectomy that is not yet widely used but > deserves special mention is the mini-laparotomy prostatectomy. > (Mini-laparotomy should not be confused with -laparoscopic- > procedures.) ... Never heard it mentioned before. Thanks for bringing it up. Alan I wouldn't recommend any LRP surgeries as they are VERY difficult for the surgeon to perform and because the length of time required is much greater than open or robotic, it's much harder on the patients long term recovery due to the anesthesia effects. Also. being in restaraints or extended periods can and often causes nerve damage that will be long lasting. And yes, I'm probably the only one that had a difficult LRP, but with the addition of Robotic LRP and the much less time on average in surgery,I would highly recommend it for capsule confined prostate cancer. I believe many under estimate the harm caused from long term anesthesia. Ron S. > A new modification of the prostectomy that is not yet widely used but > deserves special mention is the mini-laparotomy prostatectomy. [quoted text clipped - 4 lines] > removed can be a small as 4 inches, half the size of the traditional > incision." I had my prostate removed through a 2 inch incision. I do not understand the advancement in technique that is being described here. Perhaps you are thinking of a robotic procedure? B.A. >> A new modification of the prostectomy that is not yet widely used but >> deserves special mention is the mini-laparotomy prostatectomy. [quoted text clipped - 9 lines] > > B.A. I had mine removed through a 4" incision when undergoing RRP. It irks me when I read promoters of LRP or RLRP claiming RRP requires an 8" incision, more days in the hospital, more loss of blood, etc. I spent one night, had no transfusion, and, as stated, had only a 4" incision. And the RRP was about $12,000-$15,000 less expensive than RLRP. That's $12,000 to $15,000 that my insurance wouldn't cover. No irking or promoting intended! Just wondered why there would be a need for a 4 inch incision when Paul was mentioning a "mini-laparotomy prostatectomy". Perhaps he was thinking of the robotic procedure where the surgery is performed using "mini-instruments". Sorry for the mini-understanding. B.A. This sounds exactly like a typical laparoscopic procedure except for the four inch opening which is about three inches longer than normal lap procedures. Two and a half years ago I called UCSF to inquire about lap procedures and their only lap guy "was out of town" and they didn't know when he would be back. It didn't sound like it was very high on their priority list. Oakland Kaiser did not then and still doesn't do lap surgeries simply because they don't feel there is any long term health advantage to the patient. I would be surprised in Kaiser-Santa Teresa does these things since all Kaisers follow the same guidelines. I eventually had my lap procedure done by a private physician and I experienced all of the positive aspects of the procedure you list except I still need to wear a pad for drips two and a half years out. I'm one of the "extremely rare" guys. Dave Perry I had a normal RRP 3 years ago with a 2 day hospital stay, no extra blood needed, no extra pain meds, and no complications whatsoever. I liked the idea that my surgeon was able to get in quickly, fully explore and test the area, get out, and be at my bedside an hour later to give me the thumbs up based on wht he saw with his own expert eyes. Let me know when they can use the Start Trek tricorder to diagnose, and then beam out the infected area. Until then, I'm sold on the oldfashioned method.  Signature"Don't be offended I'm just SNARKY" JK Sinrod Sinrod Stained Glass Studios http://www.sinrodstudios.com/ Coney Island Memories www.sinrodstudios.com/coneymemories/ > .... I eventually had my lap procedure done by a private > physician and I experienced all of the positive aspects of the > procedure you list except I still need to wear a pad for drips two and > a half years out. I'm one of the "extremely rare" guys. Dave, I've noticed over the years that all of the negative effects I've ever experienced from any doctor's treatment have been "extremely rare". It's funny thing how many people have extremely rare side effects. Alan |
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