Authors

S. Chauhan; R. F. Coelho; B. Rocco; K. J. Palmer; M. A. Orvieto;V. R. Patel

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Abbreviated Journal Title

Int. Braz J Urol

Keywords

prostatic neoplasm; prostatectomy; robotics; outcomes; VATTIKUTI-INSTITUTE PROSTATECTOMY; SEXUAL FUNCTION OUTCOMES; RADICAL; PROSTATECTOMY; NEUROVASCULAR BUNDLE; PRESERVATION; EXPERIENCE; FEASIBILITY; Urology & Nephrology

Abstract

Purpose: Nerve sparing radical prostatectomy is the gold standard for the treatment of prostate cancer. Over the past decade, more and more surgeons and patients are opting for a robot-assisted procedure. The purpose of this paper is to briefly review different techniques and outcomes of nerve sparing robot assisted laparoscopic prostatectomy (RALP). Materials and Methods: We performed a MEDLINE search from 2001 to 2009 using the keywords "robotic prostatectomy", "cavernosal nerve", "pelvic neuroanatomy", "potency", "outcomes" and "comparison". Extended search was also performed using the references from these articles. Results: Several techniques of nerve sparing are available in literature for RALP, which have been described in this manuscript. These include, "the veil of Aphrodite", "athermal retrograde neurovascular release", "clipless antegrade nerve sparing" and "clipless cautery free technique". The comparative and the non comparative series showing outcomes of RALP have been described in the manuscript. Conclusions: The basic principles for nerve sparing revolve around minimal traction, athermal dissection, and approaching the correct planes. It has not been documented if any one technique is better than the other. Regardless of technique, patient selection, wise clinical judgment and a careful dissection are the keys to achieve optimal oncological outcomes following RALP.

Journal Title

International Braz J Urol

Volume

36

Issue/Number

3

Publication Date

1-1-2010

Document Type

Review

Language

English

First Page

259

Last Page

271

WOS Identifier

WOS:000283288600002

ISSN

1677-5538

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