Re: Saint-Elie et al.: Impact of Laparoscopic Inguinal Hernia Mesh on Open Radical Retropubic Prostatectomy (Urology 2010;76:1078-1082)
2011; Elsevier BV; Volume: 77; Issue: 4 Linguagem: Inglês
10.1016/j.urology.2010.12.062
ISSN1527-9995
AutoresDavid Canes, Alireza Moinzadeh, Andrea Sorcini,
Tópico(s)Diverticular Disease and Complications
ResumoWe read with interest Saint-Elie and Marshall's 1 Saint-Elie D.T. Marshall F.F. Impact of laparoscopic inguinal hernia mesh on open radical retropubic prostatectomy. Urology. 2010; 76: 1078-1082 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar description of a challenging cohort of 21 patients undergoing successful open radical retropubic prostatectomy (RRP) after laparoscopic mesh herniorrhaphy (LIHR). In the discussion section, brief mention was made of minimally invasive laparoscopic or robotic prostatectomy (MIRP). The potential benefit of MIRP acknowledged by the authors is “magnification,” which, in our view, has little to do with the rationale for a minimally invasive approach in these patients. Impact of Laparoscopic Inguinal Hernia Repair Mesh on Open Radical Retropubic ProstatectomyUrologyVol. 76Issue 5PreviewOpen radical retropubic prostatectomies (RRP) have been abandoned after previous laparoscopic inguinal hernia repair (LIHR) with mesh, which can be a relative contraindication to open RRP. Radiation therapy and radical perineal prostatectomy are alternative treatment options for prostate cancer when faced with this dilemma. Our objective is to report our experience with open RRP after LIHR. Full-Text PDF Reply by the AuthorsUrologyVol. 77Issue 4PreviewAs the authors correctly point out, a minimally invasive laparoscopic or robotic procedure from the periumbilical area might allow an easier dissection under the mesh. In some patients, large amounts of mesh have been tacked across the symphysis, and the bladder dissection can be difficult from any approach. We have also performed lymph node dissections in patients with higher-stage or higher-grade disease. These node dissections can be difficult and have not always been performed. A minimally invasive lymphadenectomy may not provide any additional advantage over an open approach. Full-Text PDF
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