da vinci question - extraperitoneal vs. transperitoneal ?

Talked to 3 surgeons in Texas - Slawin in Houston performs this surgery w/ the extraperitoneal method. He feels this is safer because no entry into the abdominal cavity. The other 2 use the transperitoneal because there is more room and faster.
Anyone know the lowdown?
Thanks

Post Edited (laswell) : 9/13/2007 3:32:45 PM (GMT-6)

Laswell,

Those who have the robotic surgery with the incisions above/near the navel have camera and tools inserted into the abdominal (peritoneal) cavity and then through the internal abdominal wall, into the pubic (trans-peritoneal) cavity.
I think  - but am not certain - it is three incisions into the abdominal and two directly into the pubic cavity.   [Aside: My physicians only got just the camera through my internal wall as there were too many adhesions from prior pubic and abdomnial cavity surgeries.  Then they abandoned robotic and opened me up with a"bikni cut" into the pubic cavity - just below the navel.  (This aborted attempt at robotic was predicted by all physicians consulted - including Maten at M.D. Anderson.)]

I imagine that under certain conditions, the lack of incisions through this internal wall between cavities could significant. 
 
I wonder if the trans-peritoneal technique facilitates as much or better precision?
Less trauma?  Better healing rates?  Less blood loss?  (Time would be an issue.)  Fewer complications?  Less incontinece & E.D issues?
The experienced and respected surgeons I talked to all used the peritoneal cavity for three of five incisions.

Da Vinci is new.  This "trans-peritoneal" technique could become the standard.
Perhaps they will reduce the size of the intruments for certain areas?

C^Cedar
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