Cos’è la prostatectomia radicale laparoscopica?

La prostatectomia radicale laparoscopica rappresenta la metodica all’avanguardia per affrontare questo delicatissimo intervento che viene proposto ai pazienti affetti da neoplasia della prostata localizzata alla ghiandola. L’approccio laparoscopico per tale intervento è nato nell’anno 2000, a Parigi, per mano dell’Urologo francese Guilloneau.

In questi pochi anni tale metodica ha determinato una vera e propria rivoluzione copernicana nella cultura urologica. Infatti, tale approccio endoscopico, avvalendosi dell’utilizzo di una telecamera a sua volta collegata a una ottica telescopica, ha permesso una magnificazione dell’immagine fino a otto volte, e la possibilità di eseguire l’intervento con un punto di vista “all’interno del corpo umano”.

Tale innovazione ha squarciato l’orizzonte all’urologo, offrendogli una nuova visione dell’anatomia pelvica e, conseguentemente, permettendogli di vedere un “nuovo mondo” anatomico fino ad allora conosciuto solo in teoria. 

Proprio grazie a questi dati, negli ultimi dieci anni, si è riscritta l’anatomia della prostata e dei suoi involucri fasciali. Tutto ciò oggi permette all’Urologo di offrire al paziente, in rapporto al tipo di malattia di cui è affetto, un approccio extra, inter o intrafasciale.

Illustrazione 1 - Urologia

 

Quali sono i vantaggi?

Queste diverse metodologie di intervento consentono, in pazienti selezionati e con malattia molto iniziale, di eseguire una tecnica “nerve sparing” - cioè di risparmio nervoso - volto alla salvaguardia della funzione erettile e della continenza urinaria. Una visione così dettagliata consente inoltre un controllo molto più attento e preciso del sanguinamento.

Altrettanto importante è il fatto che tutto l’intervento viene condotto con l’utilizzo di 4-5 “buchi” (porte) il cui diametro massimo è di 12 mm. L’assenza di grandi cicatrici permette quindi la salvaguardia dell’immagine corporea del paziente e una ripresa molto più rapida delle attività lavorative e della vita di relazione.
 

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