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    Laparoscopic Radical Prostatectomy Alone or With Laparoscopic Herniorrhaphy
    (SOC LAPAROENDOSCOPIC SURGEONS, 2015) Celik, Orcun; Akand, Murat; Ekin, Gokhan; Duman, Ibrahim; Ilbey, Yusuf Ozlem; Erdogru, Tibet
    Background and Objectives: Prostate cancer and inguinal hernia are common health issues in men aged more than 50 years. Recently, more data are accumulating that laparoscopic radical prostatectomy (LRP) and laparoscopic inguinal hernia repair (LIHR) can be performed in the same operation. The purpose of this study was to compare patients who underwent simultaneous extraperitoneal LRP (E-LRP) and LIHR with control patients who underwent only E-LRP in a matched-pairs design. Methods: Medical records of 215 patients were evaluated, and 20 patients who underwent E-LRP + LIHR were compared with 40 patients who underwent only E-LRP in a matched-pairs analysis. Preoperative clinical parameters (age, body mass index, prostate-specific antigen, clinical stage, Gleason score of the prostate biopsy, and prostate volume) and operative data (operation time, duration of catheterization, length of hospital stay, estimated blood loss, time to perform the anastomosis and its quality, and the percentage of patients with bilateral lymphadenectomy) were evaluated, as well as postoperative parameters (pathological stage, Gleason score, specimen weight, follow-up duration, biochemical recurrence, complication rates, and duration of postoperative analgesic treatment). Results: No statistically significant differences were found in the preoperative and operative parameters between the 2 study groups. Pathological parameters and the follow-up period and complication rates were similar between the 2 groups. Conclusion: Performing LIHR and E-LRP during the same operation is safe and feasible in the treatment of patients with prostate cancer and inguinal hernia.
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    Simultaneous augmentation ileo-cystoplasty in renal transplantation
    (ELSEVIER SCIENCE INC, 2007) Dinckan, Ayhan; Turkyilmaz, Serdar; Tekin, Ahmet; Erdogru, Tibet; Kocak, Huseyin; Mesci, Ayhan; Gurkan, Alihan
    INTRODUCTION Renal transplantation is not contraindicated in end-stage renal disease developing as a result of complication of overactive bladder with uninhibited detrusor contractions. As an amendatory Surgical approach, augmentation ileo-cystoplasty is the preferred option to achieve a low intravesical storage pressure. However, the timing of the augmentation ileo-cystoplasty in combination with renal transplantation is still controversial. TECHNICAL CONSIDERATIONS We analyzed data from 3 of the 1100 renal transplantation patients treated at the Akdeniz University Transplantation Center in whom concomitant augmentation ileo-cystoplasty and renal transplantation were performed owing to hypocompliant bladder. CONCLUSIONS The operation times were 360, 270, and 240 minutes. No perioperative major complication or rejection was detected. Bladder augmentation using ileum patch can be concomitantly performed with renal transplantation safety, and this approach avoids the requirement for a second operation in another session.
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    Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study
    (WILEY-BLACKWELL, 2015) Akand, Murat; Erdogru, Tibet; Avci, Egemen; Ates, Mutlu
    ObjectivesTo compare operative, pathological, and functional results of transperitoneal and extraperitoneal robot-assisted laparoscopic radical prostatectomy carried out by a single surgeon. MethodsAfter having experience with 32 transperitoneal laparoscopic radical prostatectomies, 317 extraperitoneal laparoscopic radical prostatectomies, 30 transperitoneal robot-assisted laparoscopic radical prostatectomies and 10 extraperitoneal robot-assisted laparoscopic radical prostatectomies, 120 patients with prostate cancer were enrolled in this prospective randomized study and underwent either transperitoneal or extraperitoneal robot-assisted laparoscopic radical prostatectomy. The main outcome parameters between the two study groups were compared. ResultsNo significant difference was found for age, body mass index, preoperative prostate-specific antigen, clinical and pathological stage, Gleason score on biopsy and prostatectomy specimen, tumor volume, positive surgical margin, and lymph node status. Transperitoneal robot-assisted laparoscopic radical prostatectomy had shorter trocar insertion time (16.0 vs 25.9min for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, P<0.001), whereas extraperitoneal robot-assisted laparoscopic radical prostatectomy had shorter console time (101.5 vs 118.3min, respectively, P<0.001). Total operation time and total anesthesia time were found to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy, without statistical significance (200.9 vs 193.2min; 221.8 vs 213.3min, respectively). Estimated blood loss was found to be lower for extraperitoneal robot-assisted laparoscopic radical prostatectomy (P=0.001). Catheterization and hospitalization times were observed to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (7.3 vs 5.8days and 3.1 vs 2.3days for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, respectively, P<0.05). The time to oral diet was significantly shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (32.3 vs 20.1h, P=0.031). Functional outcomes (continence and erection) and complication rates were similar in both groups. ConclusionsExtraperitoneal robot-assisted laparoscopic radical prostatectomy seems to be a good alternative to transperitoneal robot-assisted laparoscopic radical prostatectomy with similar operative, pathological and functional results. As the surgical field remains away from the bowel, postoperative return to normal diet and early discharge can be favored.