MP68-16 INTRAOPERATIVE ANGIOGRAPHY OF THE NEUROVASCULAR BUNDLE IMPROVES ANATOMICAL DISSECTION DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY: INITIAL CLINICAL EXPERIENCE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP68-16 INTRAOPERATIVE ANGIOGRAPHY OF THE NEUROVASCULAR BUNDLE IMPROVES ANATOMICAL DISSECTION DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY: INITIAL CLINICAL EXPERIENCE Nordine Amara, Tarek A. L. Youssef, Jordan Massa, Elias Elkhouri, Adel Ait Kaki, Aouad Fidjel, and Belur Patel Nordine AmaraNordine Amara More articles by this author , Tarek A. L. YoussefTarek A. L. Youssef More articles by this author , Jordan MassaJordan Massa More articles by this author , Elias ElkhouriElias Elkhouri More articles by this author , Adel Ait KakiAdel Ait Kaki More articles by this author , Aouad FidjelAouad Fidjel More articles by this author , and Belur PatelBelur Patel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003331.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Based on current knowledge of the surgical anatomy of the prostate we investigated the value of intraoperative angiography of the neurovascular bundle (NVB) using indocyanine green (ICG) and near-infrared fluorescence (ICG-NIRF) during robot-assisted radical prostatectomy (RARP) to provide a better dissection and preservation of the NVB. METHODS: Retrospective, unicentric study of 91 consecutive patients from 2016 to 2021. In patients who met the inclusion criteria (stage T1 and T2 (stage T3 excluded), mild-moderate ED (assessed using the Sexual Health Inventory for Men scores or SHIM Score), prostate specific antigen <10 ng/ml), we used intraoperative ICG-NIRF angiography (using the built-in Firefly fluorescence imaging system). All patients provided signed informed consent for inclusion in our study. We evaluated the proportion (%) of bilateral NVB identified to optimise and facilitate the dissection, as well as any ICG-related complications that occurred (assessed using the Clavien-Dindo classification). All patients were followed up at 3, 6, 9, and 12 months after surgery to evaluate their erectile function using the SHIM score. RESULTS: Ninety-one patients received intraoperative angiography. The NVB was identified in all cases, without difficulties. No ICG-related complications or allergies were observed.There was no significant difference in the SHIM score at 9 months compared with baseline(p=0.331), and erectile dysfunction returned to baseline levels in almost all patients. CONCLUSIONS: Intraoperative, real-time ICG-NIRF angiography is simple, non-invasive, and improves identification of key anatomical landmarks to optimise micropreservation of the NVB during RARP and preserve erectile function. Larger clinical studies should confirm preliminary results. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e959 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nordine Amara More articles by this author Tarek A. L. Youssef More articles by this author Jordan Massa More articles by this author Elias Elkhouri More articles by this author Adel Ait Kaki More articles by this author Aouad Fidjel More articles by this author Belur Patel More articles by this author Expand All Advertisement PDF downloadLoading ...