Reply by the Authors
2011; Elsevier BV; Volume: 77; Issue: 4 Linguagem: Inglês
10.1016/j.urology.2011.01.012
ISSN1527-9995
AutoresDaniel T. Saint‐Elie, Fray F. Marshall,
Tópico(s)Pelvic and Acetabular Injuries
ResumoAs 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. Rather than an intra-abdominal approach or a minimally invasive approach, a perineal prostatectomy might actually be just as, or more, appropriate. The real lesson is to have all potential approaches available so that the best approach can be selected for the specific patient. Re: Saint-Elie et al.: Impact of Laparoscopic Inguinal Hernia Mesh on Open Radical Retropubic Prostatectomy (Urology 2010;76:1078-1082)UrologyVol. 77Issue 4PreviewWe read with interest Saint-Elie and Marshall's1 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. Full-Text PDF
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