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Related Experiment Video

Updated: Apr 27, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Athermal bladder neck dissection during robot-assisted radical prostatectomy.

Fabrizio Dal Moro1

  • 1Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|July 11, 2014
PubMed
Summary

Preserving the bladder neck (BN) during robot-assisted radical prostatectomy (RARP) through athermal dissection aids urinary continence. This technique also helps identify potential cancer infiltration without increasing positive surgical margins.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Robot-assisted radical prostatectomy (RARP) techniques are refined to improve functional outcomes.
  • Postoperative urinary incontinence remains a significant challenge after RARP.
  • The bladder neck (BN) functions as an internal sphincter, crucial for continence.

Purpose of the Study:

  • To demonstrate an anatomical athermal dissection technique for the bladder neck (BN) during RARP.
  • To highlight the importance of preserving the longitudinal fibres of the BN.

Main Methods:

  • Utilizing an athermal dissection plane between the prostate and bladder after endopelvic fascia incision.
  • Minimizing traumatic effects on the longitudinal fibres of the BN.
  • Employing cold section for preserved BN to maintain sphincteric structure integrity.

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Main Results:

  • Preservation of the longitudinal fibres of the BN spares the natural sphincteric mechanism.
  • Difficult athermal dissection may indicate neoplastic infiltration, suggesting BN sacrifice to avoid positive surgical margins.
  • No increase in positive surgical margins (PSM) was observed in the series using this technique.

Conclusions:

  • This surgical technique preserves the natural BN mechanism, potentially improving urinary continence.
  • The technique facilitates easy identification of neoplastic infiltration.
  • It allows for oncological adequacy while enhancing functional outcomes.