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  5. Nerve-sparing Technique

Nerve-sparing Technique

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UCLA Institute of Urologic Oncology

Nerve-sparing Technique (step-by-step guide)

The figures below are taken from three step-by-step guides published to help other surgeons improve technique and outcomes. In particular, the guide demonstrates the landmarks for attaining the correct nerve sparing surgical plane and the equally important technique for minimizing trauma to the neurovascular bundle by avoiding stretch injury.

1. SV Dissection
1. SV dissection
1. SV Dissection
2. Cut and peel on arteries
1. SV Dissection
3. SV dissected out bilaterally
4. Defining the anterior
4. Defining the anterior contour
Creating the window
5. Creating the window for the lateral pedicle ligation
Intrafascial Nervesparing
6. Intrafascial Nervesparing
interfascial nerve-sparing for higher risk, higher volume tumors
7. Interfascial nerve-sparing for higher risk, higher volume tumors
8_suction_counter_traction
8. Suction counter-traction contributes to neurapraxia
9_R_intermittent_blunt_dissection
9. R Intermittent blunt dissection and neurapraxia
10_L_intermittent_blunt_dissection
10. L intermittent blunt dissection and neurapraxia
11_R_sharp_dissection
11. R sharp dissection emphasis
12_L_vertical_spread
12. L vertical spread
13_Lateral_pedicle_ligation
13. Lateral pedicle ligation landmarks

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