Department of Urology, Global Robotics Institute, Florida Hospital Celebration Health, University of Central Florida, Orlando, FL, USA.
The James Cancer Center, Ohio State University, Columbus, OH, USA.
J Robot Surg. 2009 Mar;3(1):13-7. doi: 10.1007/s11701-009-0127-9. Epub 2009 Feb 3.
While cancer control is the primary objective of radical prostatectomy, maintenance of sexual function is a priority for the majority of men presenting with prostate cancer. Preservation of the neurovascular bundles is the challenging and critical step of radical prostatectomy with regards to maintenance of potency. The objective of this study is to describe the surgical steps of our hybrid technique: athermal early retrograde release of the neurovascular bundle during nerve-sparing robotic-assisted laparoscopic radical prostatectomy. This technique involves releasing the neurovascular bundle in a retrograde direction from the apex toward the base of the prostate, during an antegrade prostatectomy. It is a hybrid of the traditional open and the laparoscopic approaches to nerve sparing. With this approach we are able to clearly delineate the path of the bundle and avoid inadvertently injuring it when controlling the prostatic pedicle. Our hybrid nerve-sparing technique combines aspects of the traditional open anatomical approach with those of the laparoscopic antegrade approach. The benefits of robotic technology allow a retrograde neurovascular bundle dissection to be performed during an antegrade radical prostatectomy.
虽然癌症控制是根治性前列腺切除术的主要目标，但对于大多数患有前列腺癌的男性来说，保持性功能是首要任务。保留神经血管束是根治性前列腺切除术维持勃起功能的关键和关键步骤。本研究的目的是描述我们的混合技术的手术步骤：在神经保留机器人辅助腹腔镜根治性前列腺切除术中，对神经血管束进行无热逆行早期释放。该技术涉及在前列腺顺行切除过程中，从前列腺尖端向底部逆行释放神经血管束。它是传统开放手术和腹腔镜神经保留手术的结合。通过这种方法，我们能够清楚地描绘束的路径，并在控制前列腺蒂时避免无意中损伤它。我们的混合神经保留技术结合了传统开放解剖方法和腹腔镜前向方法的优点。机器人技术的优势允许在顺行根治性前列腺切除术中进行逆行神经血管束解剖。
