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