Abstract
Functional and oncological outcomes with male nerve sparing robotic assisted radical cystectomy
Highlights
Over 1.72 million people worldwide live with bladder cancer (BC), half of them are from the North America and Europe and men are affected about 4 times more than women[1]
This review aims to study the technique of male nerve sparing (NS) robotic assisted radical cystectomy (RARC), review the results available in the literature, and examine the status of their functional outcomes and survival outcomes with longer term follow up
Its three surgically distinct zones include the proximal neurovascular plate (PNP), containing the cell bodies of the pelvic plexus, which is in close proximity to the seminal vesicles (SVs) as above, the predominant neurovascular bundle (PNVB) in the groove between posterolateral prostate and rectum, and the accessory nerve pathways (ANPs) on the lateral surface of the prostate in the lateral prostatic fascia[10,11]
Summary
Over 1.72 million people worldwide live with bladder cancer (BC), half of them are from the North America and Europe and men are affected about 4 times more than women[1]. BC accounts for the highest lifetime treatment cost per patient among all cancers, with the United States spending €3.6 billion[2] and Europe another €5 billion[3] per year on the investigation and management of BC. Muscle invasive BCs and occasionally high-grade superficial BCs are managed surgically by radical cystectomy. This is a morbid operation with prolonged recovery time and complications that may be long lasting in some patients. After Clayman performed the first laparoscopic nephrectomy in 1991, a minimally invasive approach was promoted by urologists for various procedures. More complicated operations like prostatectomy were performed laparoscopically, but minimally invasive surgery really came into its own when the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) came into play[6]. With the advent of robotic assistance in urology and the emergence of robotic assisted radical cystectomy (RARC), allowing better dexterity and visibility, the boundaries have been pushed and expectations have improved
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