Three-dimensional Camera Systems Assistant the Sheath of Prostate Preservation Laparoscopic Radical Prostatectomy: Technique and Initial Experience

Abstract Background: To report our refinement of laparoscopic radical prostatectomy by preservation of the sheath of prostate (SPP-LRP) and 1-year follow-up results. Methods: SPP-LRP was performed in 39 consecutive patients diagnosed as clinically localized prostate cancer from January 2016 to December 2018. The inclusion criteria consisted of Gleason score ≤7, tPSA＜10 ng/ml, positive in no more than 3 in 12 needles by systematical puncture biopsy, less than 50% tumor core involvement, clinical stage T1-2, good potency. The oncological results were identified by postoperative pathology test. Functional outcomes, including continence and potency, were followed postoperatively. Results: The mean operation time was 108.3±35.2 min and the mean estimated blood loss was 129.3±46.4 ml with no transfusion. The catheter was removed 7 days after the surgery. There were no relevant postoperative complications requiring intervention. The histopathological results showed 2 cases (6.1%) in pT2 and 1 case (16.7%) in pT3 presented positive resection margins for tumor (R1). Only 1 case (pT3a,Gleason score 8) suffered pelvic lymph node metastasis. No biochemical relapse was observed after 1-year follow-up. The continence rates were 71.8% and 87.2% after 1 and 3 months, and no patients suffered G2 incontinence after 6 months , and 97.4% recovered continence after 12 months. The potency rates were 61.5% and 82.1% after 1 and 3 months, and that was 92.3% after 12 months. Conclusion: SPP-LRP is a practical and worth-promoting technique for RP. The initial results are preferable and promising in technical, oncological and functional aspects.