Open retropubic simple prostatectomy is occasionally performed for symptomatic large volume benign prostatic hyperplasia(BPH). We describe the technique of laparoscop?c simple prostatectomy and we present our 3 cases with this procedure robot assisted.

74 patients with symptomatic BPH (ultrasound determined prostate volume > 60cc) and/or coexisting pathology that would a favor a surgical approach were candidates for this technique. The steps of our extraperitoneal 5-port technique: transverse cystotomy, retraction of the median lobe, development of the subcapsular plane, enucleation,urethral transection,trigonization and suture-repair of the prostatic capsule. During robot assisted technique, we performed the same steps but transperitoneal approach.

In the laparoscopic cases the mean age was 69 years. Mean operative time was 141 min( 75-180 min), mean estimated blood loss was 293ml(100-700ml). mean hospital stay was 1.3 days(1-3days), and duration of the Foley catheter was 7 days (3-7 days). Mean specimen weight on pathology was 77 g (30-200).

Laparoscopic simple prostatectomy is a feasible and safe alternative to open surgery. Greater experience is required before determining its role in surgical management of BPH. The Robot assited technique was promising too.