Surgeon Resources and Benefits
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Live da Vinci® Prostatectomy Surgery
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Variability in Nerve Location During da Vinci ® Prostatectomy
R. Kuhn
Conclusions: The use of the ProPep Nerve Monitoring System during dVP identified the otherwise invisible PBPN which innervates the pelvic floor in 100% of the cases. Both the nerve location relative to the prostate as well as the nerve distance from the prostate varied from case to case with the most common location occurring only 50% of the time. Given the importance of nerve preservation for urinary control recovery, the documented inability for surgeon perception to predict nerve location, and the documented variability of nerve location from case to case, the use of the ProPep Nerve Monitoring System is an effective tool for improving the accuracy of nerve identification and could improve the preservation of these nerves and the clinical outcomes achieved by patients.
R. Kuhn
Conclusions: The use of the ProPep Nerve Monitoring System during dVP identified the otherwise invisible PBPN which innervates the pelvic floor in 100% of the cases. Both the nerve location relative to the prostate as well as the nerve distance from the prostate varied from case to case with the most common location occurring only 50% of the time. Given the importance of nerve preservation for urinary control recovery, the documented inability for surgeon perception to predict nerve location, and the documented variability of nerve location from case to case, the use of the ProPep Nerve Monitoring System is an effective tool for improving the accuracy of nerve identification and could improve the preservation of these nerves and the clinical outcomes achieved by patients.
| variability_in_nerve_location-kuhn.pdf |
 click to view larger version |
Results of Using a New Technology to Improve the Identification and Preservation of Nerve Tissue during Robotic-Assisted Laparoscopic Radical Prostatectomy | R. Kuhn
Efforts to improve continence after robotic-assisted laparoscopic radical prostatectomy (RALRP) have focused on preserving periurethral and bladder neck tissue and techniques involving posterior reconstructions and anterior suspensions. Many patients, however, still have varying degrees of urinary incontinence. Literature has shown that nerves innervating the levator ani (LA) contribute to continence and anatomic landmarks are not accurate in determining their location. Inadvertent damage to these nerves may therefore contribute to post RALRP incontinence.
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| results_of_using_a_new_technology_to_improve_-_aua_2013_presentation.pdf |
Early Return of Continence Using a Novel Tool for Identification of the Perineal Branch of Pudendal Nerve During da Vinci Prostatectomy
N. Kella
Conclusions: The use of the ProPep Nerve Monitoring System during dVP allowed for accurate, easy, and efficient identification of the otherwise invisible PBPN in 100% of cases. In addition, only patients whose post-dissection waveform latency was less than 11.5ms were wearing 1 pad per day or less with minimal urinary bother at 8 weeks post surgery. It is the Authors’ belief that use of this equipment provides real-time information that surgeons can use to avoid inadvertent injury to this important nerve during dVP and to possibly predict early urinary control recovery.
N. Kella
Conclusions: The use of the ProPep Nerve Monitoring System during dVP allowed for accurate, easy, and efficient identification of the otherwise invisible PBPN in 100% of cases. In addition, only patients whose post-dissection waveform latency was less than 11.5ms were wearing 1 pad per day or less with minimal urinary bother at 8 weeks post surgery. It is the Authors’ belief that use of this equipment provides real-time information that surgeons can use to avoid inadvertent injury to this important nerve during dVP and to possibly predict early urinary control recovery.
| early_return_of_continence-kella.pdf |
Surgeon perception is not a good predictor of peri-operative outcomes in robot-assisted radical prostatectomy
Joshua Stern, Saurabh Sharma, Pierre Mendoza, Mary Walicki, Rachel Hastings, Kelly Monahan, Baber Sheikh, Alexei Wedmid and David I. Lee
Joshua Stern, Saurabh Sharma, Pierre Mendoza, Mary Walicki, Rachel Hastings, Kelly Monahan, Baber Sheikh, Alexei Wedmid and David I. Lee
| surgeon_perception_is_not_a_good_predictor_of_surgical_outcomes._lee.pdf |
Pelvic Autonomic Nerve Mapping Around the Prostate by Intraoperative Electrical Stimulation With Simultaneous Measurement of Intracavernous and Intraurethral Pressure Atsushi Takenaka,* Ashutosh Tewari, Rouei Hara, Robert A. Leung, Kohei Kurokawa, Gen Murakami and Masato Fujisawa
| nerve_mapping_ash_tewari.pdf |
Dr. Randy Fagin speaks about several clinical papers supporting the use of nerve monitoring during da Vinci robotic prostatectomy (video)
