Contact Request

EERPE-Prostatectomy

Endoscopic extraperitoneal radical prostatectomy (EERPE) is a novel laparoscopy technique for prostate cancer surgery developed by Professor Stolzenburg and colleagues at the University of Leipzig, Germany. In EERPE, the surgeon avoids the peritoneal cavity and creates a pre-peritoneal space from which to access the prostate. This differs from the transperitoneal approach used in laparoscopic radical prostatectomy (LRP), and may help reduce intraperitoneal complications.

During EERPE, the patient is placed supine on the operating table with the legs slightly apart, and with their head down at a 10° tilt. Five small incisions are made in the abdomen to allow endoscopic equipment access. A balloon trocar is inserted into the pre-peritoneal space and inflated, which, along with blunt dissection, enlarges the space. From this space, the dissection of the bladder proceeds, allowing access to the vas, the seminal vesicles and the prostate. These are dissected following a standardised 12-step procedure. Minor variations in the procedure allow the sparing of nerves, whenever possible.

A published case series reporting the experience of Prof. Stolzenburg and his colleagues showed that EERPE resulted in high levels of continence and potency 12 months after the procedure. Levels of potency were particularly high in patients who had undergone bilateral nerve sparing procedures. The overall efficacy of EERPE compared with trans-peritoneal LRP is likely to depending on the experience of the individual surgeon. However, EERPE has now become a standard procedure in a variety of European centres.

Step - Bladder Neck Dissection

Without angulation, rigid 30°
Avoids bladder blocking the view and clashing with the energy device.

Step - Bladder Neck Dissection

Without angulation, rigid 30°
Avoids bladder blocking the view and clashing with the energy device.

Step - Bladder Neck Dissection

With angulation, LTF
Avoids bladder blocking the view and clashing with the energy device.

Step - Bladder Neck Dissection

With angulation, LTF
Avoids bladder blocking the view and clashing with the energy device.

Step - Dissection of the Prostatic Pedicles and Nerve Sparing

With angulation, LTF
Provides detailed visual information and highest level of precise tissue preparation.

Step - Dissection of the Prostatic Pedicles and Nerve Sparing

With angulation, LTF
Provides detailed visual information and highest level of precise tissue preparation.

Step - Apical Dissection

Without angulation, rigid 30°
Allows for safe observation of the energy device tip for the apical dissection at all times.

Step - Apical Dissection

Without angulation, rigid 30°
Allows for safe observation of the energy device tip for the apical dissection at all times.

Step - Apical Dissection

With angulation, LTF
Allows for safe observation of the energy device tip for the apical dissection at all times.

Step - Apical Dissection

With angulation, LTF
Allows for safe observation of the energy device tip for the apical dissection at all times.

Olympus supplies all of the equipment necessary for an efficient EERPE procedure. This includes all of the devices recommended for the endoscopy tower, including monitor, insufflator, light source, electrosurgery generator and ultrasonic surgery system. Olympus’ HD video telescope, coupled with the VISERA ELITE Video System will provide superb HD video images to guide EERPE procedures. Olympus also supplies all of the necessary hand instruments and energy devices for a successful outcome.

Laparoscopic procedure improves post-operative outcomes

EERPE offers faster recovery, less pain, reduced blood loss and a shorter hospital stay.

Extraperitoneal nerve sparing radical prostatectomy improves continence

In a case series of over 2000 patients, 12 months after EERPE, 93.2% of patients were completely continent, with just 0.6% requiring >2 pads per day.

Extraperitoneal nerve sparing radical prostatectomy improves potency

The 12-month potency rate in patients who had undergone unilateral and bilateral nerve sparing EERPE was 33.3% and 78.5%, respectively.

EERPE gives clear surgical margins

The rate of positive surgical margins was 6.3% in pT2 and 21.2% in pT3 specimens, respectively, in the case series of over 2000 patients.

Contact and Support

What Can We Help You With?

Contact Us

Whether you’re looking for answers, would like to solve a problem, or just need to get in touch, you can contact us right here.

To Contact Form

Event Calendar

Find out more about our certified international medical expert training courses in over 25 reference centers across 13 countries in Europe.

To our Trainings and Events

Media Center

Discover our Media Center for further information about our products and services, such as brochures, documents, images, and videos.

To our Media Center