Preoperative MR may assist surgeons in nerve sparing during robotic prostatectomy

Preoperative MR can help surgeons limit nerve damage while performing a robotic assisted laparascopic prostatectomy (RALP)–saving some men from becoming impotent, according to a study performed at the University of California, Los Angeles, CA.

Preoperative MR was used to evaluate 38 neurovascular bundles in 19 men who were set to undergo RALP. “Prostate MR changed the neurovascular resection plan in 20/38 neurovascular bundles,” said Timothy McClure, MD, lead author of the study. “12/20 underwent a more aggressive nerve sparing technique and 8/20 underwent a more conservative nerve sparing technique. Both aggressive and conservative techniques are less likely to cause impotency than RALP,” said Dr. McClure.

“RALP is becoming more common. When using the robot in surgery, the surgeon has improved visualization and manual dexterity but at a loss of sense of touch,” he said.

“MR before RALP appears to help surgeons make a more informed decision with regards to the aggressiveness of nerve sparing surgical technique without compromising the oncologic outcome,” said Dr. McClure.

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