Radical prostatectomy, or removal of the prostate and surrounding tissues, is a standard surgical procedure used to treat men with prostate cancer. Robot-assisted radical prostatectomy (RARP) is becoming more common, but as with other radical prostatectomy techniques, urinary incontinence and erectile dysfunction are frequent complications of the procedure.
The surgeon’s experience and technique strongly influence the outcome prostate cancer surgery, and the incidence of recurrence is greatly reduced as surgical experience and techniques improve. In 2008, the hydrodissection method was modified for use in robotics at the Roswell Park Comprehensive Cancer Center by an experienced team led by Dr. Med. honey Surgery.
“During RARP hydrodissection, saline is injected into the neurovascular bundles where nerves and thin blood vessels lie to facilitate dissection,” says Dr. Guru, who remains at the world’s forefront of improvement and application of technology. “This technique allows the surgeon to dissect these important structures with minimal tension or cauterization, which helps preserve important nerves and blood vessel around the prostate to restore urination control and sexual function after the operation. “
In a study recently published in Video Journal of UrologyDr. Guru and a team of urologists-oncologists compared the results of radical prostatectomy in 76 men with prostate cancer who chose RARP hydrodissection compared with 126 men who chose conventional surgical dissection techniques. Both groups had the same success rates in terms of cancer control, but patients who underwent RARP hydrodissection had earlier and improved urinary incidence than patients who underwent standard dissection. Three months after surgery, 77% of men who underwent RARP hydrodissection regained restraint compared with 32% of men who underwent standard radical prostatectomy. Six months later, these rates were 87% in the hydrodissection group compared with 53% in the standard dissection group. In addition, potency rates were slightly better for the new technology group.
“Urologists are striving to find a balance between achieving the best cancer and functional success for their patients,” says Ahmed Elsaed, MD, researcher in the urology department and first author of the study. “For men who pass radical prostatectomyPreservation of these important structures offers a faster way to restore their sexual function and control urination. prostatectomy. Keeping the nerves to improve the functional outcomes and satisfaction of patients without compromising the fight against cancer is possible in centers of excellence such as Roswell Park ”.
Dr. Guru’s team will continue to closely monitor patients with RARP hydrodissection to gain a better understanding of long-term outcomes in terms of sexual function and urinary control, in order to preserve urinary and sexual function without compromising cancer control.
“Our results only add to the confidence we have in educating our patients, who are often faced with huge choices during cancer treatment”Adds Ahmed Ali, MD, PhD, surgeon in the urology department and senior author of the study. “Our technology does not compromise the safety or effectiveness of the operation and can significantly improve the quality of life. ”
Ahmed S. Elsaed et al., Preservation of endothelial fascia, pubic-prostatic ligaments, dorsal venous complex and hydrodissection of neurovascular bundles during radical prostatectomy with the help of a robot: video demonstration and results of predisposition, Video Journal of Urology (2022). DOI: 10.1016 / j.urolvj.2022.100143
Roswell Park Cancer Institute
Citation: New surgical technique allows faster, more complete recovery after radical prostatectomy (2022, May 10), obtained May 10, 2022 from https://medicalxpress.com/news/2022-05-surgical-technique-enables-faster -fuller.html
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