In the hands of an experienced surgeon nerve and seminal vesicle sparing robot-assisted radical cystectomy with intracorporeal reconstruction of the neobladder seems feasible and safe. It provides short-term oncologic efficacy and promising functional outcomes. Yet comparative, long-term followup studies with standard open cystectomy are required.

The preservation of sexual potency after radical prostatectomy has always been the topic of much anxiety and debate. While cancer control and urinary continence are of supreme importance, the preservation of sexual function completes the trifecta that both patient and surgeon strive to achieve. The introduction of robotic assistance to modern laparoscopic surgery has provided many advantages, the two greatest being improved three-dimensional magnified vision and wristed instrumentation. These technical enhancements provide the surgeon with improved surgical tools that have the potential to facilitate a more precise surgical approach. One of the potential advantages during robot-assisted laparoscopic prostatectomy (RALP) is improving visualization, control, and dissection of the neurovascular bundle (NVB). With this article, we provide the description of our current technique of intrafascial, tension and energy-free dissection of the NVB during RALP, aiming to maximize the preservation of the periprostatic neuronal network and improve erectile function outcomes. A step-by-step description of the preservation of the pubovesical complex is also provided.

No abstract

No abstract