V6-08 NEUROVASCULAR BUNDLE PRESERVATION IN ROBOT-ASSISTED RADICAL PROSTATECTOMY: A VARIATION OF THE ANTEROGRADE TECHNIQUE.

Abstract

You have accessJournal of UrologyNovel Imaging/Prostate Oncology/Robotics1 Apr 2014V6-08 NEUROVASCULAR BUNDLE PRESERVATION IN ROBOT-ASSISTED RADICAL PROSTATECTOMY: A VARIATION OF THE ANTEROGRADE TECHNIQUE. Alfredo Velasco, Ruben Olivares, Cristobal Roman, Lucas Spencer, Camilo Leon, Ivan Pinto, Felipe Balbontin, Manuel Diaz, Cristian Wohler, Jose Miguel Cabello, Pablo Marchetti, Renato Cabello, Sergio Moreno, Gonzalo Azocar, Javier Aviles, and Alvaro Kompatzki Alfredo VelascoAlfredo Velasco More articles by this author , Ruben OlivaresRuben Olivares More articles by this author , Cristobal RomanCristobal Roman More articles by this author , Lucas SpencerLucas Spencer More articles by this author , Camilo LeonCamilo Leon More articles by this author , Ivan PintoIvan Pinto More articles by this author , Felipe BalbontinFelipe Balbontin More articles by this author , Manuel DiazManuel Diaz More articles by this author , Cristian WohlerCristian Wohler More articles by this author , Jose Miguel CabelloJose Miguel Cabello More articles by this author , Pablo MarchettiPablo Marchetti More articles by this author , Renato CabelloRenato Cabello More articles by this author , Sergio MorenoSergio Moreno More articles by this author , Gonzalo AzocarGonzalo Azocar More articles by this author , Javier AvilesJavier Aviles More articles by this author , and Alvaro KompatzkiAlvaro Kompatzki More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1871AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Robot-Assisted Radical Prostatectomy (RARP) has commonly dissected the neurovascular bundle by anterograde approach, either inside the fascia or outside. In the Open Radical Prostatectomy (ORP), the nerve-sparring technique commonly uses the retrograde dissection. In the RARP the retrograde approach is no used, because of the risk of rectum injury, due to scope limitations in the angle of view. In the RARP the Seminal Vesicle (SV) dissection is also by anterograde approach, same as in the ORP. However when SV dissection is performed by posterior approach and it is dissected until the apex is reached, it is possible to perform a retrograde preservation with 30-grades scope view, without risk of rectum injury. This technique has never been described. METHODS A single Robot-assisted Radical Prostatectomy with the technique description, and neurovascular preservation is presented, using the Da Vinci SI Surgical System. Technique for posterior approach of the SV and retrograde dissection of the neurovascular bundle with 30-grade angle scope is explained. RESULTS No damage or injury to the neurovascular bundle was performed, allowing complete neural integrity and functionality. CONCLUSIONS The RARP requires a proper training, which consolidates over time, as the number of cases increases. Urologists are more familiar with retrograde nerve preservation, because of their access on the open surgery. The posterior dissection of the SV completely frees the prostate from rectum, preserving the innervation without risk of damaging the rectum. We believe that this variation allows a better conservation and more appropriate handling by the surgeon, as it is more trained in this surgical approach. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e680 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Alfredo Velasco More articles by this author Ruben Olivares More articles by this author Cristobal Roman More articles by this author Lucas Spencer More articles by this author Camilo Leon More articles by this author Ivan Pinto More articles by this author Felipe Balbontin More articles by this author Manuel Diaz More articles by this author Cristian Wohler More articles by this author Jose Miguel Cabello More articles by this author Pablo Marchetti More articles by this author Renato Cabello More articles by this author Sergio Moreno More articles by this author Gonzalo Azocar More articles by this author Javier Aviles More articles by this author Alvaro Kompatzki More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...