The application of natural orifice surgery for adenocarcinoma of the prostate

Prostate cancer remains the most common solid organ malignancy in men. Unfortunately, surgical management of this disease is often associated with significant morbidity. In an effort to decrease the invasiveness and deleterious impact on quality of life associated with prostate cancer surgery, minimally invasive techniques have been applied to this disease. At present, the robotic-assisted laparoscopic radical prostatectomy has become the most commonly performed surgical treatment modality for adenocarcinoma of the prostate. Recently, several centers within the United States have begun to evaluate the feasibility of applying natural orifice translumenal endoscopic surgery to prostate cancer. This review article details the initial work done on cadaveric and canine models to develop the transurethral radical prostatectomy procedure. Potential advantages and disadvantages of this modality, as well as challenges facing its continued development, are highlighted.