THE MIRANDOLINO'S TECHNIQUE

Until the end of the 20th century surgery for benign prostatic hyperplasia was opened, through technical retropubic by Irish surgeon Terence Millin (1947). In 1999, Dr. Mirandolino Mariano makes the first laparoscopic surgery, publishing case report of the technique in 2002, in Journal of the American Urological Association.

First described in the article Laparoscopic Prostatectomy with Vascular Control for Benign Prostatic Hyperplasia, with vascular control, without bleeding, the technique is indicated for prostate above 75 grams. In 2005, Dr. Mirandolino publishes new article, this time in Journal of European Urology Association with 60 cases’ experience (1999-2005): Laparoscopic Prostatectomy for Benign Prostatic Hyperplasia – Six-Year Experience.

Mirandolino’s technique is a paradigm of the medicine’s evolution in one century. In 1896, the prostate surgery for benign disease performed by the Irish surgeon Peter Freyer opened the abdomen and then the bladder to remove the prostate through the bladder. Led to much bleeding, difficulty narrowing of the urethra and therefore was used for a few years. In 1905, Yank did surgery via perineal, which not evolved.

These two incipient techniques were used until 1934 when Joseph McCarthy used scraping by inside the urethra to remove part of the prostate. Until today that’s the best technique for prostate from 20 to 40 grams.

In 1947, another Irish surgeon, Terence Millin, developed retropubic surgery: to open the abdomen and going directly to the prostate. The new technique with laparoscopy is performed half a century later, in 1999, by Dr. Mirandolino Mariano in Brazil. The Mirandolino’s technique was adopted initially in the USA, Colombia and some countries of Europe and more recently in Brazil. Many doctors trained by Dr. Mirandolino in several courses, as the Urovídeo, Goiânia, now use the technique.