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Year : 2014  |  Volume : 30  |  Issue : 4  |  Page : 399-409

Newer concepts in neural anatomy and neurovascular preservation in robotic radical prostatectomy

1 Department of Urology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY 10029, USA
2 Department of Pathology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY 10029, USA

Correspondence Address:
Ashutosh K Tewari
Department of Urology, The Carroll and Milton Petrie Foundation, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, L6-50, New York, NY 10029
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Source of Support: None, Conflict of Interest: Dr. Ashutosh Tewari discloses that he is the principal investigator on research grants from Intuitive Surgical, Inc. (Sunnyvale, CA, USA) and Boston Scientific Corporation; he is a non-compensated director of the Prostate Cancer Institute (Pune, India) and Global Prostate Cancer Research Foundation; he has received research funding from the Prostate Cancer Foundation, The LeFrak Family Foundation, Mr. and Mrs. Paul Kanavos, Craig Effron & Company, Charles Evans Foundation and Christian and Heidi Lange Family Foundation. Dr. Sailaja Pisipati and Dr. Adnan Ali are recipients of the Prostate Cancer Foundation Young Investigator Award.

DOI: 10.4103/0970-1591.142064

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With more than 60% of radical prostatectomies being performed robotically, robotic-assisted laparoscopic prostatectomy (RALP) has largely replaced the open and laparoscopic approaches and has become the standard of care surgical treatment option for localized prostate cancer in the United States. Accomplishing negative surgical margins while preserving functional outcomes of sexual function and continence play a significant role in determining the success of surgical intervention, particularly since the advent of nerve-sparing (NS) robotic prostatectomy. Recent evidence suggests that NS surgery improves continence in addition to sexual function. In this review, we describe the neuroanatomical concepts and recent developments in the NS technique of RALP with a view to improving the "trifecta" outcomes.

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