[Laparoscopic adenomectomy: Evolution of the technique and results]

Abstract

Objective: Laparoscopic adenomectomy (LA) is an effective procedure for the treatment of benign prostatic hyperplasia (BPH), which reproduces the surgical steps of the open adenomectomy (OA) by a minimally invasive approach to obtain the favorable results of open surgery in combination with the benefits offered by laparoscopic techniques. We performed a comprehensive bibliographic review of the technique and its current results in order to describe the evolution of the surgical technique and present the current evidence on the LA.

Methods: A comprehensive review about LA was conducted from 2002 to 2016 in PubMed and Google Scholar. We included articles with perioperative data and abstracts presented at international urological meetings using the search words "laparoscopic adenomectomy" and "laparoscopic simple prostatectomy". A total of 110 publications were reviewed, including articles in indexed journals, not indexed journals, chapters in medical books and abstracts presented at meetings.

Results: A total of 50 articles were selected, thirty of which relate to LA, 17 to the technique of Robot-assisted LA (R-LA), 3 to Laparoendoscopic Single-site Surgery- LA, 13 to comparative studies with other techniques, 5 are review articles and 2 large volume multicenter studies. The evolutionary history of the LA technique was presented with an update on the current results evidenced in studies.

Conclusion: LA and R-LA are procedures under continuous "development" of some complexity that require experience in laparoscopy and/or robotics. These techniques offer significant advantages compared to the OA, so they are reasonable alternatives, effective and safe in the treatment of BPH in laparoscopic or robotic centers or with interest in the development of these techniques.