Laparoscopic radical prostatectomy - A new approach to treatment

Radical prostatectomy has been pioneered at Johns Hopkins over the last 100 years. In 1904, Hugh Hampton Young, the first Director of Urology at the Brady Urological Institute and the founder of modern urology, pioneered the perineal approach - a technique that is still in use today.

In the 1970s Dr. Patrick C. Walsh, the current Director of the Brady Urological Institute, described an anatomical approach to radical prostatectomy. His pioneering work made possible an operation that resulted in less blood loss, improved urinary control, and preservation of sexual function. This operation, the nerve-sparing radical retropubic prostatectomy, remains the standard of care for the surgical treatment of prostate cancer and has proven to cure organ-confined prostate cancer with fewer side effects than in the past.

A new approach to radical prostatectomy is on the horizon - laparoscopic radical prostatectomy. This technique utilizes small laparoscopic instrumentation inserted through keyhole incisions in the abdomen to dissect and remove the cancerous prostate gland without the surgeon's hands ever entering the patient's abdomen. The principles of dissection of the prostate gland as well as preservation of urinary continence and sexual function based on the anatomic approach described by Dr. Walsh are adhered to during the laparoscopic technique.

Members of the faculty at the Brady Urological Institute were involved in early techniques of laparoscopic radical prostatectomy approximately 10 years ago. With new innovations in technology, this technique has now reached the horizon for further application. Refinements and standardization of the laparoscopic prostatectomy technique have recently been made by several institutions in France, which have since adopted laparoscopic prostatectomy as their standard of care. Several institutions within the United States, including Johns Hopkins, have adopted their technique and begun to offer laparoscopic prostatectomy as a less invasive surgical alternative for men with organ-confined prostate cancer.

For more information regarding laparoscopic prostatectomy, please refer to our Patient Information Guide. If you are considering laparoscopic radical prostatectomy and would like to be evaluated at the Brady Urological Institute at Johns Hopkins, please contact Li-Ming Su, M.D. (lsu11@jhmi.edu ) or Christian Pavlovich, M.D. (cpavlov2@jhmi.edu) or call their offices at 410-550-3506 (Dr. Su) or (410) 550-0013 (Dr. Pavlovich) to arrange for an appointment.