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Anatomic Basis of Nerve-Sparing Robotic Prostatectomy

  • Sandhya Rao
  • Atsushi Takenaka
  • Ashutosh Tewari

Abstract

It is estimated that, in 2005, prostate cancer will be diagnosed in over 232,090 men in the United States and that 30,350 men will die from the disease.1 Radical retropubic prostatectomy offers an effective cure,2–4 but is associated with significant postoperative morbidity, including erectile dysfunction and incontinence.5,6 The development of nerve-sparing anatomic prostatectomy by Walsh and colleagues has lead to improved potency rates.7,8 However, the results regarding potency preservation published in the literature by many centers are not satisfactory.5,6

Keywords

Radical Prostatectomy Seminal Vesicle Neurovascular Bundle Radical Retropubic Prostatectomy Laparoscopic Radical Prostatectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Prostate Cancer Fact Sheet. American Cancer Society. Available from: http://www.cancer.org.Google Scholar
  2. 2.
    Walsh PC. Radical prostatectomy for localized prostate cancer provides durable cancer control with excellent quality of life: a structured debate. J Urol 2000;163:1802–1807.PubMedCrossRefGoogle Scholar
  3. 3.
    Han M, Partin AW, Pound CR, Epstein JI, Walsh PC. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 2001;28:555–565.PubMedCrossRefGoogle Scholar
  4. 4.
    Han M, Partin AW, Piantadosi S, Epstein JI, Walsh PC. Era specific biochemical recurrence-free survival following radical prostatectomy for clinically localized prostate cancer. J Urol 2001;166:416–419.PubMedCrossRefGoogle Scholar
  5. 5.
    Fischetti G, Cuzari S, De Martino P, et al. Postprostatectomy erectile dysfunction. Personal experience. Minerva Urol Nefrol 2001;53:185–188.PubMedGoogle Scholar
  6. 6.
    Chang SS, Peterson M, Smith JA Jr. Intraoperative nerve stimulation predicts postoperative potency. Urology 2001;58:594–597.PubMedCrossRefGoogle Scholar
  7. 7.
    Walsh PC, Lepor H, Eggleston JC. Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate 1983;4:473–485.PubMedCrossRefGoogle Scholar
  8. 8.
    Walsh PC, Mostwin JL. Radical prostatectomy and cystoprostatectomy with preservation of potency. Results using a new nerve-sparing technique. Br J Urol 1984;56:694–697.PubMedCrossRefGoogle Scholar
  9. 9.
    Walsh PC. Anatomic radical prostatectomy: evolution of the surgical technique. J Urol 1998;160: 2418–2424.PubMedCrossRefGoogle Scholar
  10. 10.
    Walsh PC. Radical prostatectomy, preservation of sexual function, cancer control. The controversy. Urol Clin North Am 1987;14:663–673.PubMedGoogle Scholar
  11. 11.
    Walsh PC. Nerve sparing radical prostatectomy for early stage prostate cancer. Semin Oncol 1988; 15:351–358.PubMedGoogle Scholar
  12. 12.
    Walsh PC. Radical retropubic prostatectomy with reduced morbidity: an anatomic approach. NCI Monogr 1988;7:133–137.PubMedGoogle Scholar
  13. 13.
    Abbou CC, Salomon L, Hoznek A, et al. Laparoscopic radical prostatectomy: preliminary results. Urology 2000;55:630–634.PubMedCrossRefGoogle Scholar
  14. 14.
    Abbou CC, Hoznek A, Salomon L, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol 2001;165:1964–1966.PubMedCrossRefGoogle Scholar
  15. 15.
    Gill IS, Zippe CD. Laparoscopic radical prostatectomy: technique. Urol Clin North Am 2001;28: 423–436.PubMedCrossRefGoogle Scholar
  16. 16.
    Guillonneau B, Rozet F, Barret E, Cathelineau X, Vallancien G. Laparoscopic radical prostatectomy: assessment after 240 procedures. Urol Clin North Am 2001;28:189–202.PubMedCrossRefGoogle Scholar
  17. 17.
    Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000;163:1643–1649.PubMedCrossRefGoogle Scholar
  18. 18.
    Rassweiler J, Sentker L, Seemann O, Hatzinger M, Rumpelt HJ. Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol 2001;166:2101–2108.PubMedCrossRefGoogle Scholar
  19. 19.
    Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology 1997;50: 854–857.PubMedCrossRefGoogle Scholar
  20. 20.
    Schulam PG, Link RE. Laparoscopic radical prostatectomy. World J Urol 2000;18:278–282.PubMedCrossRefGoogle Scholar
  21. 21.
    Turk IS, Deger B, Winkelmann J, et al. Laparoscopic radical prostatectomy. Experiences with 145 interventions. Urologe A 2001;40:199–206.PubMedCrossRefGoogle Scholar
  22. 22.
    Menon M, Tewari A, Baize B, Guillonneau B, Vallancien G. Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology 2002;60:864–868.PubMedCrossRefGoogle Scholar
  23. 23.
    Menon M, Tewari A, Peabody JO. The VIP Team: Vattikuti Institute prostatectomy: technique. J Urol 2003;169:2289–2292.PubMedCrossRefGoogle Scholar
  24. 24.
    Tewari A, Peabody JO, Sarle R, et al. Technique of da Vinci robot-assisted anatomic radical prostatectomy. Urology 2002;60:569–572.PubMedCrossRefGoogle Scholar
  25. 25.
    Menon M, Shrivastava A, Tewari A, et al. Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol 2002;168: 945–949.PubMedCrossRefGoogle Scholar
  26. 26.
    Tewari A, Peabody JO, Fischer M, et al. An operative and anatomic study to help in nerve sparing during laparoscopic and robotic radical prostatectomy. Eur Urol 2003;43:444–454.PubMedCrossRefGoogle Scholar
  27. 27.
    Walsh PC. Anatomic radical retropubic prostatectomy. In: Walsh PC, Retik AB, Vaughan ED Jr., Wein AJ, eds. Campbell’s Urology, 8th ed. Philadelphia: W.B. Saunders; 2002:3109.Google Scholar
  28. 28.
    Costello AJ, Brooks M, Cole OJ. Anatomical studies of the neurovascular bundle and cavernosal nerves. BJU Int 2004;94:1071–1076.PubMedCrossRefGoogle Scholar
  29. 29.
    Tewari A, Takenaka A, Mtui E, et al. The proximal neurovascular plate (PNP) and the tri-zonal neural architecture around the prostate gland —importance in athermal robotic technique (ART) of nervesparing prostatectomy. BJU Int 2006;98(2):314–323.PubMedCrossRefGoogle Scholar
  30. 30.
    Takenaka A, Murakami G, Soga H, et al. Anatomical analysis of the neurovascular bundle supplying penile cavernous tissue to ensure a reliable nerve graft after radical prostatectomy. J Urol 2004;172:1032–1035.PubMedCrossRefGoogle Scholar
  31. 31.
    Kiyoshima K, Yokomizo A, Yoshida T, et al. Anatomical features of periprostatic tissue and its surroundings: a histological analysis of 79 radical retropubic prostatectomy specimens. Jpn J Clin Oncol 2004;34:463–468.PubMedCrossRefGoogle Scholar
  32. 32.
    Takenaka A, Murakami G, Matsubara A, Han SH, Fujisawa M. Variation in course of cavernous nerve with special reference to details of topographic relationships near prostatic apex: histologic study using male cadavers. Urology 2005;65:136–142.PubMedCrossRefGoogle Scholar
  33. 33.
    Lunacek A, Schwentner C, Fritsch H, Bartsch G, Strasser H. Anatomical radical retropubic prostatectomy: “curtain dissection” of the neurovascular bundle. BJU Int 2005;95:1226–1231.PubMedCrossRefGoogle Scholar
  34. 34.
    Strasser H, Bartsch G. Anatomy and innervation of the rhabdosphincter of the male urethra. Semin Urol Oncol 2000;18:2–8.PubMedGoogle Scholar
  35. 35.
    Yucel S, Baskin LS. Neuroanatomy of the male urethra and perineum. BJU Int 2003;92:624–630.PubMedCrossRefGoogle Scholar
  36. 36.
    Yucel S, Baskin LS. An anatomical description of the male and female urethral sphincter complex. J Urol 2004;171:1890–1897.PubMedCrossRefGoogle Scholar
  37. 37.
    Steiner MS. Anatomic basis for the continencepreserving radical retropubic prostatectomy. Semin Urol Oncol 2000;18:9–18.PubMedGoogle Scholar
  38. 38.
    Tewari A, El-Hakim A, Horninger W, et al. Nervesparing during robotic radical prostatectomy: use of computer modeling and anatomic data to establish critical steps and maneuvers. Curr Urol Rep 2005;6:126–128.PubMedCrossRefGoogle Scholar
  39. 39.
    Menon M, Hemal AK, VIP Team. Vattikuti Institute Prostatectomy: a technique of robotic radical prostatectomy: experience in more than 1000 cases. J Endourol 2004;18:611–619.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2007

Authors and Affiliations

  • Sandhya Rao
    • 1
  • Atsushi Takenaka
    • 2
  • Ashutosh Tewari
    • 3
  1. 1.Department of UrologyWeill Medical College of Cornell UniversityNew YorkUSA
  2. 2.Department of Organs TherapeuticsKobe University Graduate School of MedicineKobeJapan
  3. 3.Brady Urology Department New York Presbyterian Hospital/Weill CornellMedical CollegeNew YorkUSA

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