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A prostatectomy is the surgical removal of all or part of the prostate gland. Abnormalities of the prostate, such as a tumour, or if the gland itself becomes enlarged for any reason, can restrict the normal flow of urine along the urethra. Laparoscopic radical prostatectomy (LRP) is a modern form of radical prostatectomy, an operation for prostate cancer. The laparoscopic and open forms of radical prostatectomy physically remove the entire prostate and reconstruct the urethra directly to the bladder.
Laparoscopic radical prostatectomy and open radical prostatectomy differ in how they access the deep pelvis and generate operative views. In contrast to open radical prostatectomy, the laparoscopic radical prostatectomy makes no use of retractors and does not require that the abdominal wall be parted and stretched for the duration of the operation.
Laparoscopic radical prostatectomy is performed under general anesthesia or epidural anesthesia. Several small cuts instead of one big cut are made. Long, thin tools and the laparascope are placed inside the cuts. This helps the surgeon see inside the belly during the procedure. The prostate gland is removed from the surrounding tissue, the seminal vesicles, two small fluid filled sacs next to the prostate, are sometimes also removed. The surgeon reattaches the urethra to a part of the bladder called the bladder neck. The urethra is the tube that carries urine from the bladder out through the penis. Many surgeons will also remove lymph nodes in the pelvis to check for cancer. The surgeon may leave a drain, called a Jackson-Pratt drain, in the belly to drain extra fluids after surgery. A tube or urinary catheter is left in the bladder to drain urine.