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Related Experiment Video

Updated: Jul 17, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Retzius-Sparing Robot-Assisted Radical Prostatectomy

Published on: May 19, 2022

Laser nerve-sparing laparoscopic radical prostatectomy: a feasibility study.

Troy R J Gianduzzo1, Christopher M Chang, Mohammed El-Shazly

  • 1Departments of Urology and Pathology, The North Hampshire Hospital, Basingstoke, Hampshire, UK.

BJU International
|January 25, 2007
PubMed
Summary

This pilot study found that using a laser for nerve-sparing laparoscopic radical prostatectomy (NSLRP) is feasible, offering rapid dissection with minimal blood loss and tissue injury. Further research is recommended for this promising technique.

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Area of Science:

  • Urology
  • Surgical Technology
  • Oncology

Background:

  • Nerve-sparing laparoscopic radical prostatectomy (NSLRP) requires precise dissection of the neurovascular bundle (NVB) with minimal collateral damage.
  • Current methods for NVB dissection may cause significant blood loss and tissue trauma.
  • Lasers offer potential for precise energy delivery, rapid dissection, and effective hemostasis.

Purpose of the Study:

  • To evaluate the feasibility of using a 1064 nm Nd:YAG laser for NVB dissection during NSLRP in a pilot study.
  • To assess the safety, efficacy, and impact on operative parameters of laser-assisted NVB dissection.

Main Methods:

  • Five patients underwent NSLRP.
  • In the first patient, one NVB was dissected with a laser, and the other with traditional clips and scissors.

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  • The remaining four patients had bilateral NVB dissection using the Nd:YAG laser (8 W, continuous-wave).
  • Excised NVBs were sent for histological analysis to assess tissue injury.

    • Main Results:

    • Laser dissection in the first patient resulted in significantly less blood loss (20 mL) compared to the control side (100 mL).
    • In the subsequent four patients, mean operative time was 214 min, mean NVB dissection time was 22 min, and mean total blood loss was 213 mL.
    • Mean estimated NVB blood loss was 28 mL, with a mean depth of laser-induced tissue necrosis of 687 microm.
    • No intraoperative complications occurred, and patients achieved continence with no recurrence at 12-month follow-up.

    Conclusions:

    • Laser-assisted NVB dissection during NSLRP is a feasible and straightforward technique.
    • The method demonstrated minimal blood loss and adjacent tissue injury.
    • Laser dissection appears promising for improving outcomes in nerve-sparing prostatectomy and warrants further investigation.