Natural orifice surgery removes cancerous prostate through penis
12 August 2010
Urologists at Mayo Clinic in Arizona have developed a new surgical procedure for the treatment of prostate cancer through the urethra, so that there is no incision on the body.
This type of procedure, called Natural Orifice Transluminal Endoscopic Surgery, or NOTES, has advanced over the past several years and now, it is believed for the first time, a NOTES procedure has been perfected to remove the prostate — a radical prostatectomy or NOTES RP.
“The reason this hasn’t been done in prostate surgery before is because of the challenge of rejoining or suturing the bladder back to the urethra,” said Mitchell Humphreys MD, urologist at Mayo Clinic in Arizona. “To do this, we have developed specialized techniques and instruments that allow us to do all the work through the urethra, preventing the need for any incisions in the skin whatsoever.”
The specialised instruments are inserted through the penis and an innovative technique is used to remove the entire prostate. Surgeons then rejoin the internal tissues via specialized instruments designed to work through the urethra. Patients benefit from the procedure because there are no incisions, little risk of bleeding and are usually able to leave the hospital within 24 hours.
The first patient who had a NOTES RP has done well and has had no problems or complications throughout any part of the operation in late June.
“This really shows that the impossible is now possible and represents a paradigm shift not only in the way we look at diseases, but also how we surgically treat disease,” Dr. Humphreys said.
Prostate cancer is one of the most commonly diagnosed malignancies in men. Standard surgical therapy involves removal of the prostate through open, laparoscopic, or robot-assisted laparoscopic means. Each of these approaches does the same thing by removing the entire prostate, and presumably the cancer, and then suturing (or sewing) the bladder back to the urethra to restore the continuity of the urinary system.
For decades surgical procedures have strived to become more and more minimally invasive in order to limit potential complications and speed up recovery for patients without compromising disease control.
The recent surgery by Dr. Humphreys is a culmination of more than two and a half years of research and development between James Lingeman MD, of Indianapolis, and Jude Sauer MD, with his research team from Rochester, New York, and the team at Mayo including Paul Andrews, MD, Chair of the Department of Urology at Mayo Clinic in Arizona.
Video below: Mitchell Humphreys, M.D., urologist at Mayo Clinic in Arizona Physicians at Mayo Clinic in Arizona talks about the procedure