Se reportan los primeros dos casos de prostatectomía radical laparoscópica (PRL) realizada por urólogos costarricenses. La PRL se realizó con colocación de 4 trócares luego de poner la cámara en cicatriz umbilical. El tiempo operatorio total fue de 240 y 205 minutos, la pérdida de sangre estimada fue de 150 y 100 ml respectivamente. Se extrajeron las próstatas con vesículas seminales por una incisión umbilical de 3 cm. Un dreno cerrado con succión se externalizó por una de las incisiones de los trócares de 5mm. No hubo complicaciones trans ni post operatorias. La estadia hospitalaria post operatoria fue de 3 y 2 días, el dreno se retiró al tercer y segundo día post operado y las sondas Foley se retiraron a los 14 días. Las próstatas pesaron 27 y 23 gramos, los puntajes Gleason fueron de (3+4) y (3+3) ambos tuvieron márgenes negativos, sin infiltración vascular ni nerviosa. La PRL es un procedimiento mínimamente invasivo para hombres con cáncer de próstata órgano confinado realizable, seguro y reproducible. Con mejor resultado cosmético y menor dolor posoperatorio.

We herein report the first two cases of laparoscopic radical prostatectomy (LRP) performed by Costarican Urologists. Two 50 and 64-year-old patients respectively, with an adenocarcinoma of the prostate with Gleason scores (3+ 3) 6, diagnosed trough transrectal ultrasonografic guided biopsies, indicated by an elevation of the prostate specific antigen (PSA) or abnormal rectal digital examination (DRE). The LRP was performed transperitonealy with Montsouris technique using standard laparoscopy instruments and high definition laparoscopic video tower.

 After placing a 10mm camera port through the umbilicus, the procedure was accomplished with 4 trocars. The entire operative time was 240 and 205 minutes, whereas the blood loss was 150 and 100 ml respectively. The extraction of the specimens with seminal vesicles was through a 3 cm. umbilical incision. A closed drainage system was left in place through one of the 5mm port incisions. There were no complications trans or post operative, the time of hospitalization was 3 and 2 days respectively, and the drain was retrieved third and second day postoperative. Moreover, an indwelling Foley catheter was removed 14 days in an outpatient setting. The pathology department reported that both prostates weighed 27 and 23 grams each, and had a Gleason score (3+ 4) 7 and (3+3) 6 respectively. In addition, both specimens were reported to have negative margins, without neurovascular infiltration.

In conclusion, LPR is a safe, feasible and reproducible a minimally invasive procedure for men with confined prostate cancer, with better cosmesis, less bleeding and less postoperative pain.