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Nerve-sparing Techniques for Laparoscopic and Robot-assisted Radical Prostatectomy

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Robotic Urology

Abstract

The preservation of sexual potency after prostatectomy has always been the topic of much anxiety and debate. While cancer control and urinary continence are of supreme importance, the preservation of sexual function completes the trifecta that both patient and surgeon strive to achieve. Over the decades open nerve-sparing radical prostatectomy has continued to evolve from its early rudimentary beginnings into the more refined techniques that we see at present; however, while we have seen considerable advances in recent times, the limitations in visualization and dissection of the bundle have continued to provide a challenge to even the most experienced surgeon. The introduction of robotic assistance to modern laparoscopic surgery has provided many advantages, the two greatest being improved three-dimensional magnified vision and wristed instrumentation. These technical enhancements provide the surgeon with improved surgical tools that have the potential to facilitate a more precise surgical approach. One of the potential advantages during robotic prostatectomy is improving visualization, control, and dissection of the neurovascular bundle (NVB). In this chapter we present the pertinent anatomy and the various technical approaches to nerve sparing during robotic radical prostatectomy.

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Author information

Authors and Affiliations

  1. Center for Robotic and Computer-Assisted Surgery, Department of Urology, The Ohio State University – The James Cancer Hospital, 410 W 10th Ave, 43210, Columbus, OH , USA

    K.K. Shah, K.J. Palmer & R. Thaly

  2. Department of Urology, Center for Robotics and Computer-assisted Surgery, Ohio State University Medical Center, 538 Doan Hill, 410 West 10th Avenue, 43210, Columbus, OH, USA

    M.F. Chammas Jr.

  3. Global Robotics Institute, Florida Hospital, 400 Celebration Place, 34747, Celebration, FL , USA

    V.R. Patel

Authors
  1. K.K. Shah
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  2. M.F. Chammas Jr.
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  3. K.J. Palmer
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  4. R. Thaly
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  5. V.R. Patel
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Editor information

Editors and Affiliations

  1. Zentrum für Urologie, Klinik Hirslanden, 8032, Zurich, Switzerland

    Hubert John

  2. Department of Urology, Karolinska University Hospital, 17176, Stockholm, Sweden

    Peter Wiklund

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© 2008 Springer-Verlag Berlin Heidelberg

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Shah, K., Chammas, M., Palmer, K., Thaly, R., Patel, V. (2008). Nerve-sparing Techniques for Laparoscopic and Robot-assisted Radical Prostatectomy. In: John, H., Wiklund, P. (eds) Robotic Urology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74140-4_7

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  • DOI: https://doi.org/10.1007/978-3-540-74140-4_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-74139-8

  • Online ISBN: 978-3-540-74140-4

  • eBook Packages: MedicineMedicine (R0)

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