Nerve-sparing laparoscopic radical prostatectomy: replicating the open surgical technique

Urology
L i-Ming SuChristian P Pavlovich

Abstract

To present a detailed demonstration of a nerve-sparing laparoscopic radical prostatectomy (LRP) technique that replicates anatomic nerve-sparing radical retropubic prostatectomy (RRP). Techniques for neurovascular bundle preservation during open RRP have undergone several decades of careful refinement. Identifying pre-existing anatomic planes and the avoidance of thermal injury near the nerves are principles considered paramount during nerve-sparing RRP. During LRP and robotic-assisted radical prostatectomy, the use of cautery for hemostasis during nerve dissection is common despite its unknown effects on cavernous nerve function. We describe a combined antegrade and retrograde laparoscopic approach to neurovascular bundle dissection. The technique is demonstrated in the accompanying video segments. The use of specialized laparoscopic instrumentation, including a fine-tipped right-angle clamp and curved dissector, is discussed. The principles of meticulous tissue handling and avoidance of electrocautery are stressed. The preliminary outcomes are presented using data obtained using an abridged version of the International Index of Erectile Function and the Expanded Prostate Cancer Index Composite questionnaires. To date, our tec...Continue Reading

References

Nov 1, 1996·The Journal of Urology·J A EasthamP T Scardino
Aug 6, 1997·Journal of the National Cancer Institute·J A TalcottP W Kantoff
Sep 25, 1997·The Journal of Urology·V E WeldonH Neuwirth
Jan 14, 1998·Urology·W W SchuesslerL R Kavoussi
May 3, 2000·Urology·C C AbbouD K Chopin
May 8, 2000·The Journal of Urology·B Guillonneau, G Vallancien
Aug 23, 2002·Critical Reviews in Oncology/hematology·Bertrand GuillonneauGuy Vallancien
Aug 2, 2003·Urology·Aristotelis G AnastasiadisClement-Claude Abbou

❮ Previous
Next ❯

Citations

Nov 1, 2012·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Ioana Nicolaescu FlemingEmad Boctor
Jun 15, 2006·Current Urology Reports·Matthew T Gettman, Michael L Blute
Sep 25, 2008·Journal of Endourology·Jens-Uwe StolzenburgEvangelos N Liatsikos
Sep 25, 2008·Journal of Endourology·Jens RassweilerThomas Frede
Sep 25, 2008·Journal of Endourology·R StantonS A McNeill
Jan 1, 2007·Journal of Robotic Surgery·Sashi S KommuAbhay Rané
Sep 1, 2008·Journal of Robotic Surgery·Declan G Murphy, Anthony J Costello
Aug 11, 2006·Der Urologe. Ausg. A·J RassweilerT Frede
Aug 28, 2007·Current Treatment Options in Oncology·Kevin C ZornArieh L Shalhav
Jul 13, 2006·Expert Review of Anticancer Therapy·Carter Q Le, Matthew T Gettman
Sep 26, 2007·Expert Review of Anticancer Therapy·Vipul R PatelGeoff Coughlin
Sep 2, 2008·The Urologic Clinics of North America·Mark L GonzalgoVipul R Patel
Oct 31, 2006·Urology·Avery L Seifert, Thomas R Huntington
Jan 18, 2006·European Urology·F CurtoR Gaston
Sep 8, 2005·Urologic Oncology·Michael Perrotti, Michael E Moran
Apr 9, 2005·Surgical Oncology Clinics of North America·Paul D Maroni, E David Crawford
Jul 5, 2005·International Braz J Urol : Official Journal of the Brazilian Society of Urology·M Tobias-MachadoEric R Wroclawski
Jul 8, 2008·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Rodrigo FrotaInderbir S Gill
Aug 8, 2012·Urologia Internationalis·Katsumi ShigemuraMasuo Yamashita
Jun 7, 2006·The Journal of Urology·Uwe H G MichlHartwig Huland
Apr 9, 2005·Current Opinion in Urology·András HoznekClément-Claude Abbou
Aug 7, 2009·Nature Reviews. Urology·Ahmed Magheli, Arthur L Burnett
Feb 8, 2007·Current Opinion in Urology·Adam W Levinson, Li-Ming Su
Mar 29, 2014·Experimental and Therapeutic Medicine·Yong HeArcher Page
Mar 1, 2012·Arab Journal of Urology·Sameer ChopraAshutosh Tewari

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.