Multi specialty medical centre, Columbia Asia Hospital, Hebbal has performed the first TRUS (Transrectal ultrasound) assisted Nerve sparing laparoscopic Radical prostatectomy for the first time in Bangalore and Karnataka.
The surgery has been performed successfully by Dr T Manohar, Endourologist and Laparoscopic surgeon on three patients who were suffering from prostrate cancer.
The procedure is minimally invasive and involves placing 5 ports of size 5 mm (3 in number) and 10 mm ports (2 in number) and a high definition camera placed in one of the ports via laparoscope into the pelvic region through one tiny incision unlike an open Prostatectomy where the surgeons use a large abdominal incision to access the prostate.
The main benefits of the surgery as opposed to open surgery are early recovery as it involves no major abdominal incisions. There is reduced blood loss needing a blood transfusion. Smaller incision means less pain and shorter recovery time of three days as compared to 10-12 days in open surgery. Accurate suturing of the vesicourethral junction through a high definition camera and specialized suturing technique that helps in achieving early urinary control.
Prostate cancer is the fourth most common killer cancers in the world. In India it is the in the eight most common cancer killer disease. Prostate cancer is beginning to result in three per cent fatality in men above 50 years.
The lifetime risk of developing clinically detected prostate cancer is about 16 per cent. It will also cause serious complications from local tumour growth or distant metastases and complications in treatment. Most prostate cancers detected only on the basis of elevated PSA (prostate specific antigen) are clinically important and are more likely to be curable with surgery (radical prostatectomy) than are palpable tumours. Radical prostatectomy can be done by open method, laparoscopic and robotic.
Laparoscopic Radical Prostatectomy is one of the most complex laparoscopic surgical procedures. With advances in medical technology, improved optics, and widespread use of laparoscopic aids like Harmonic (ultrasonic) scalpels, special suture materials and with adequate training laparoscopic radical prostatectomy began to be performed in several centres around the world.
Radical prostatectomy by open surgery for cancer of the prostate is by far the commonest method. However, this surgery is associated with large incisions and postoperative problems such as pain, loss of time from work, excessive blood loss, loss of urinary control and loss of erections, stated Dr. Manohar.
Laparoscopic Radical Prostatectomy is considered to be a rare one in India and very few hospitals in the country are reported to perform the surgery as it demands exceptionally high skilled and trained doctors and specialized equipment. We have utilized the intraoperative ultrasound to overcome the pitfalls of laparoscopic method and to match the accuracy of robotic surgery. This novel technique is first done in Cleveland clinic and this approach for Indians is a boon as it is cost effective and reduces the erectile dysfunction post operatively.