Abstract
Purpose:
The introduction of reduced caliber laparoscopic instruments has diminished invasiveness while preserving the triangulation laparoscopy principle. Needlescopy (2 mm), microlaparoscopy (<2 mm), and minilaparoscopy (3 mm) aim to reduce invasiveness and improve esthetic and perioperative outcomes. 1 –3 Our objective was to present the preliminary outcomes related to cosmesis and pain control assessment in ultraminilaparoscopic radical prostatectomy with three-dimensional imaging using a new set of 2.7 mm laparoscopic instruments and optics. We report the first use of this armamentarium in urology.
Methods:
Four men were operated on using these instruments between November 1, 2017, and March 31, 2018. Data were collected in a prospective manner. All participants signed the consent form before the surgery and were granted strict confidentiality. Postoperative cosmetic and pain evaluation was assessed with the use of both the visual analog scale (VAS) at discharge and the Patient Scar Assessment Questionnaire (PSAQ) score 1 and 2 weeks after the surgery. A 5-item global rating scale for laparoscopic surgeries was used for the assessment of surgeon's performance. 4
Results:
A total of three radical prostatectomies were performed. One surgery could not be completed because of a peritoneal infection. Patients were aged 66 to 71 years, with a body mass index between 25 and 32 kg/m2. The surgical time was between 105 and 120 minutes and there were no complications. No extra intravenous analgesia was required. The VAS 1 week after the surgery rated from 1 to 3 and the PSAQ 1 and 2 weeks after the surgery ranked from 31 to 41, and 31 to 44, respectively. The surgeon's perception was positive in all the cases.
Conclusions:
This new ultraminilaparoscopy (UML) set showed good results in all the surgeries. Despite its smaller diameter, outcomes and safety were not compromised. Moreover, UML offered excellent cosmetic and pain control outcomes. Surgeon perception of the surgeries was adequate in terms of deep perception, bimanual dexterity, efficiency, tissue handling, and autonomy.
No competing financial interests exist.
Runtime of video: 5 mins 34 secs
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