Abstract
The interposition sural nerve graft has been attempted occasionally during radical prostatectomy for the recovery of continence and erectile function; however, nerve autograft may result in adverse events for the patient. Here, we present our initial experiences using NerbridgeTM, a novel conduit for peripheral nerve regeneration, rather than utilizing sural nerve grafting, in robot-assisted laparoscopic radical prostatectomy to overcome autograft problems such as prolongation of operation time and postoperative abnormal sensation. This novel artificial conduit interposition can be technically feasible when combined with robotic surgery, and prospective randomized controlled trials with high patients-numbers and long follow-up periods are warranted.
Highlights
Radical prostatectomy (RP) is considered a safe and effective treatment for localized prostate cancer; the risk of urinary incontinence and erectile dysfunction are significant disadvantages compared to other modalities
The use of interposition sural nerve graft (SNG) instead of nerve sparing has been attempted in such patients, and some investigators have reported its effectiveness in the recovery of continence and erectile function [1]-[3]
SNG is performed by only an urologist with robotic assistance [4]; yet nerve autograft, which requires the extraction of a peripheral nerve from a healthy portion of the patient’s own body, carries the risk of adverse event such as prolongation of operation time and postoperative abnormal sensation
Summary
Radical prostatectomy (RP) is considered a safe and effective treatment for localized prostate cancer; the risk of urinary incontinence and erectile dysfunction are significant disadvantages compared to other modalities. (2015) Cavernous Nerve Graft Reconstruction with a Novel Artificial Conduit during Robot-Assisted Laparoscopic Radical Prostatectomy. The use of interposition sural nerve graft (SNG) instead of nerve sparing has been attempted in such patients, and some investigators have reported its effectiveness in the recovery of continence and erectile function [1]-[3]. The introduction of robot-assisted laparoscopic radical prostatectomy (RALP) has provided technical advantages for nerve grafting due to its ability to allow easier intracorporeal thin suturing and knot tying, and its improved 3-dimentional visualization with 10-fold magnification. NerbridgeTM was utilized as a conduit for peripheral nerve regeneration, rather than SNG in robotic surgery, to attempt to overcome the disadvantages associated with autografting
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