New technique in robot-assisted laparoscopic prostatectomy

Aug 02, 2010

Stress urinary incontinence is one of the most feared complications of radical prostatectomy. The weighted mean continence rate immediately after catheter removal following robot-assisted laparoscopic radical prostatectomy (RALP) is 25.7%. Evidently, early recovery of urinary continence remains a challenge to be overcome. The Surgery in Motion section of the September issue of European Urology describes the surgical steps of pubovesical complex (PVC)-sparing RALP and presents the preliminary results of the technique.

Puboprostatic ligament preservation has been proposed to achieve accelerated return of continence after nerve-sparing procedures. Even with this technique, the rates of postoperative continence remain low. A possible explanation could be that because there is demonstrable anatomic continuity with the bladder, there are no conceivable means of preserving the pubovesical ligaments during RALP, and there must be interruption at some point to expose the prostatourethral junction.

The aim of the study presented in the Surgery in Motion section of European Urology was to propose and describe the steps of a new technique of surgical dissection that maximises the preservation of the periprostatic anatomy by keeping intact the pubovesical complex (PVC; i.e. detrusor apron with pubovesical ligaments). This is the first demonstration of the feasibility of this technique in the field of RALP.

The PVC-sparing RALP was applied in 30 men with clinically localised from October 2007 to March 2009. The rate of urinary continence at catheter removal is the highest reported in the literature; the majority of patients were dry at removal, and the remainder only required the use of one security liner. Further, larger studies are needed.

Explore further: Survival hope for melanoma patients thanks to new vaccine

Provided by European Association of Urology

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Robotic prostate surgery may mean big trade-off

Oct 13, 2009

(AP) -- A new study suggests less-invasive keyhole surgery for prostate cancer may mean a higher risk for lasting incontinence and impotence when compared with traditional surgery.

Recommended for you

Survival hope for melanoma patients thanks to new vaccine

51 minutes ago

(Medical Xpress)—University of Adelaide researchers have discovered that a new trial vaccine offers the most promising treatment to date for melanoma that has spread, with increased patient survival rates and improved ability ...

New clinical trial launched for advance lung cancer

4 hours ago

Cancer Research UK is partnering with pharmaceutical companies AstraZeneca and Pfizer to create a pioneering clinical trial for patients with advanced lung cancer – marking a new era of research into personalised medicines ...

User comments : 0

More news stories

Firm targets 3D printing synthetic tissues, organs

(Medical Xpress)—A University of Oxford spin-out, OxSyBio, will develop 3D printing techniques to produce tissue-like synthetic materials for wound healing and drug delivery. In the longer term the company ...

Survival hope for melanoma patients thanks to new vaccine

(Medical Xpress)—University of Adelaide researchers have discovered that a new trial vaccine offers the most promising treatment to date for melanoma that has spread, with increased patient survival rates and improved ability ...

Naps help infants learn

Sleep is essential in helping young children apply what they learn, according to new research by Rebecca Gómez, associate professor in the UA Department of Psychology. In this Q&A, she talks about her new ...

Robotics goes micro-scale

(Phys.org) —The development of light-driven 'micro-robots' that can autonomously investigate and manipulate the nano-scale environment in a microscope comes a step closer, thanks to new research from the ...

Biologists help solve fungi mysteries

(Phys.org) —A new genetic analysis revealing the previously unknown biodiversity and distribution of thousands of fungi in North America might also reveal a previously underappreciated contributor to climate ...