Robotic Radical Prostatectomy - STEP 6- Athermal Sexual Nerve Sparing Technique

The following video will highlight the technique of robotic nerve preservation and prostate vascular pedicle control. This is video 6 of 10 in a series focused on robotic radical prostatectomy for localized prostate cancer.

One of the biggest fears of men undergoing radical prostatetomy is the loss of ability to achieve a strong enough for intercourse. Depending on a man's age, preoperative erectile function and comorbidies and the ability of the surgeon to safely spare the nerves for erections, these factors play a role in post-operative outcomes. Gleason score, the number of positive cores and their percentrage, the PSA and the clinical stage all play a role in the risk of disease being outside the prostate capsule (otherwise known or referred to as extracapsular extention (ECE)). There are several mathematical predictive models which help patients and surgeons gage the risk of ECE.

If oncologically suitable, a full nerve sparing technique can be employed. May techniques have been described however, there is growing evidence on the impact of thermal heat energy and stretch traction on sexual function outcome. As such, we employ a completely cautery-free, energy-free technique with minimal nerve traction to optimize erectile recovery after surgery.

Video by Dr. Kevin Zorn.