Hemostasis during nerve-sparing endoscopic extraperitoneal radical prostatectomy

The incidence of bleeding during laparoscopic radical prostatectomy has been reported to range between 1% and 7.6%. Postoperative bleeding complications have been encountered in 0.7% of endoscopic extraperitoneal radical prostatectomy cases and require endoscopic or open re-intervention. Thus, bleeding complications represent a significant factor of intra- and postoperative morbidity. We review our experience with endoscopic extraperitoneal radical prostatectomy, and we propose methods to prevent and manage intraoperative bleeding complications. In addition, special technical considerations regarding the nerve-sparing procedures are presented.