Re: Extraperitoneal laparoscopic millin prostatectomy using finger enucleation: P. L. Chlosta, I. M. Varkarakis, T. Drewa, J. Dobruch, J. Jaskulski, A. A. Antoniewicz and A. Borówka J Urol 2011; 186: 873-876

摘要

To the Editor: I read this article with great interest and would like to compliment the authors on a novel concept of applying open surgery laparoscopically, combining the advantage of both approaches to the patients. For prostates 70 to 100 gm, as mentioned in this study, bipolar transurethral resection of the prostate (TURP) using epidural anesthesia is the method of choice, combining the advantages of electrothermal TURP and holmium laser enucleation of the prostate. Bipolar TURP has several advantages. The approach is minimally invasive with less pain and shorter hospitalization (3 days), decreased morbidity and a low cost. The procedure also allows excellent cutting and coagulation, giving a clear field for fast resection of larger glands. In addition, it allows use of normal saline as an irrigant, making it safe for longer resection without fear of water absorption (hypervolemia) or transurethral resection syndrome (hyponatremia), as well as for hemo-dynamically unstable patients and patients with cardiac pacemakers. Finally, there is no need for morcellation with its associated problems as in holmium laser enucleation of the prostate.