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Updated: May 14, 2026
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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
NeuroSAFE-guided robot-assisted radical prostatectomy versus standard RARP: systematic review and meta-analysis of
Caio Vinicius Suartz1,2, José Pedro Cassemiro Micheleto3, Bianca Espadilha Condotta3
1Department of Urology, Northern Ontario School of Medicine University, Thunder Bay, ON, Canada. caio.v_suartz@hotmail.com.
Journal of Robotic Surgery
|May 13, 2026
Summary
NeuroSAFE intraoperative frozen sectioning improves outcomes in robotic-assisted radical prostatectomy (RARP). This technique enhances urinary continence and erectile function recovery while reducing positive surgical margins, without impacting cancer control.
Area of Science:
- Urology
- Surgical Oncology
- Pathology
Background:
- Prostate cancer is a leading male malignancy.
- Robotic-assisted radical prostatectomy (RARP) is common, but functional deficits like incontinence and erectile dysfunction persist.
- The NeuroSAFE technique aims to optimize nerve preservation during RARP, but its impact needs systematic evaluation.
Purpose of the Study:
- To systematically evaluate the effectiveness and safety of the NeuroSAFE technique in RARP.
- To compare functional recovery (urinary continence, erectile function) and oncologic outcomes between NeuroSAFE and non-NeuroSAFE RARP.
Main Methods:
- Systematic review and meta-analysis following PRISMA 2020 guidelines, registered in PROSPERO.
- Searched Embase, MEDLINE, and ClinicalTrials.gov for studies on NeuroSAFE in RARP.
- Included 13 studies (2 RCTs, 11 observational) with 22,183 patients; assessed risk of bias using ROBINS-I.
Main Results:
- NeuroSAFE significantly improved erectile function (OR 2.00) and urinary continence recovery (OR 1.36).
- Positive surgical margins were significantly reduced with NeuroSAFE (OR 0.73).
- No significant difference in biochemical recurrence was observed (OR 0.81); substantial heterogeneity noted.
Conclusions:
- NeuroSAFE is a safe and effective intraoperative strategy for RARP.
- It is associated with improved functional outcomes and reduced positive surgical margins.
- Findings support integrating NeuroSAFE into RARP decision-making for optimal nerve preservation and functional recovery.