Laparoscopic Surgery for BPH
What is Laparoscopic Surgery for BPH?
Laparoscopic surgery is a minimally invasive procedure with lower surgical trauma. It is a more advanced form of prostatectomy that is less aggressive than the traditional approach.
The surgery involves the exclusive removal of the internal part of the prostate causing the obstruction and urinary issues through insertion of a laparoscope (through which the doctor can see the area to be treated) and surgical instruments via small incisions in the skin.
Unlike radical prostatectomy, laparoscopic surgery for BPH does not remove all of the organ. The procedure is advised for patients with large prostates.
With regard to open surgery, laparoscopy has a number of advantages, such as less blood loss, shorter recovery time and shorter hospitalisation.
What is the Laparoscopic Surgery Procedure?
Before surgery, the patient undergoes a detailed clinical assessment.
The aim is to identify prior health problems such as high blood pressure, diabetes, cardiovascular problems, etc., that may increase the risk of operation.
Imaging exams, blood and urine tests, and an ECG are usually requested.
Patients must also inform the doctor about any medication they are taking. You may have to stop taking certain drugs, especially those intended to thin the blood, because they raise the risk of haemorrhaging.
By amplifying the image, this video surgery provides the surgeon with a better view of the organs to be operated on and the adjacent organs, blood vessels and nerves. As a result, delicate movements can be performed, protecting important structures during the removal of the tissue and organs.
The patient is under anaesthetic during the operation.
In laparoscopic surgery, small incisions are made in the lower abdomen through which the laparoscope and necessary surgical instruments for the procedure are inserted.
Next, a device with a light and a mini video camera is inserted into one of the orifices to help the surgeon to operate, approach the different organs and the prostate, and remove the prostate’s enlarged "nucleus". This enlarged tissue is removed through one of the small orifices in the abdomen.
The procedure reduces the side effects and risks of complication.
The patient has less post-operative pain and less risk of haemorrhaging during the operation.
This type of surgery is often less painful and involves shorter recovery time. Sometimes, it is performed using robotic aids and is called robot-assisted prostatectomy. However, and like many other urological surgeries, a robotic aid is not necessary for this procedure, because it greatly raises the treatment costs without any significant benefits.
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What is the Post-Treatment?
Laparoscopic surgery is usually followed by several days in hospital. Everything depends on the success and extent of the operation. In some cases, patients are discharged from hospital 1 to 2 days after the procedure; other patients may need to stay for a little longer.
After laparoscopic surgery, patients must expect the following:
- Bandages where the incisions were made;
- Drainage of post-operative liquids;
- Catheter to help drain bladder urine.
Patients can be discharged home with the catheter while the healing and curing process is progressing.
After surgery, the patient is assessed every day while in hospital. After discharge, the first consultation is between 15–30 days after the operation.
After the initial consultations shortly after surgery (usually up to 3 months), patients should be seen annually. A PSA test and DRE should be requested at the consultations.
The aims of this annual assessment are to evaluate the continued success of the operation and check for any signs of prostate cancer.
Dr. José Santos Dias
Clinical Director of the Instituto da Próstata
- Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
- Specialist in Urology
- Fellow of the European Board of Urology
- Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"
FAQs about Laparoscopic Surgery for BPH
What is the purpose of laparoscopic surgery for BPH?
Is the prostate completely removed during the operation?
What are the benefits of laparoscopic surgery?
Does the patient receive follow-up care after surgery?
- DIAS, José Santos. Urologia Fundamental: na prática clínica. Lisboa: Lidel - Edições Técnicas, Lda, 2010.
- DIAS, José Santos. Tudo o que sempre quis saber sobre a Próstata. Lisboa: Lidel - Edições Técnicas, Lda, 2014.
- Laparoscopic simple prostatectomy: A reasonable option for large prostatic adenomas - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518362/