Dorsal Vein Complex Preserving Technique During Robot-Assisted Radical Prostatectomy

Area of Science:

• Urology
• Robotic Surgery
• Surgical Techniques

Background:

• Robot-assisted radical prostatectomy (RARP) is a standard treatment for prostate cancer.
• Preservation of the dorsal vein complex (DVC) and neurovascular bundles (NVB) is crucial for functional outcomes.
• Existing anterior approach RARP techniques aim to simplify procedures and improve outcomes.

Purpose of the Study:

• To present a modified transperitoneal-anterior-antegrade RARP technique.
• To reduce the technical demands of RARP while preserving critical structures.
• To evaluate the safety and efficacy of this modified approach for early functional recovery.

Main Methods:

• A modified transperitoneal-anterior-antegrade RARP was performed in a 65-year-old male patient with localized prostate cancer (Gleason 6, cT2aN0M0).
• The technique involved full NVB sparing, antegrade preservation of the DVC, and division of the endopelvic fascia.
• Prostate mobility was increased to reduce surgical complexity.

Main Results:

• The patient achieved complete urinary continence the day after catheter removal.
• Erectile function recovery was observed 30 days post-surgery.
• The modified technique was associated with reduced technical demands.

Conclusions:

• The described DVC preservation technique in transperitoneal-anterior-antegrade RARP with endopelvic fascia division is safe.
• This approach may lower technical difficulty during RARP.
• Early recovery of continence and sexual function is facilitated by this modified technique.