Brandon Piyevsky, Alina Gandrabur, Paige Bird, David I Lee, Mohammad Shahait, Ryan W Dobbs
{"title":"机器人根治性前列腺切除术中的下一代神经保留技术:当代综述。","authors":"Brandon Piyevsky, Alina Gandrabur, Paige Bird, David I Lee, Mohammad Shahait, Ryan W Dobbs","doi":"10.1007/s11934-025-01292-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize the evolution and future of technologies and techniques that assist in providing good functional outcomes during nerve-sparing robot-assisted radical prostatectomy.</p><p><strong>Recent findings: </strong>Recent data underscore the value of preoperative optimization, including structured weight loss and pharmacologic interventions such as GLP-1 receptor agonists, in facilitating safer and more precise nerve-sparing. Advances in imaging and surgical planning, including 3D modeling and augmented reality, have enhanced anatomic visualization and margin control. Intraoperative adjuncts such as frozen section analysis (NeuroSAFE), nerve mapping and fluorescence guidance are being evaluated to minimize neural injury. Next-generation robotic systems incorporating haptic feedback and intraoperative penile oxygen monitoring may provide real-time functional assessment. Early series suggest these technologies can improve early continence and potency recovery, though long-term validation is needed. The future of nerve-sparing prostatectomy lies in a precision-based, multimodal framework that integrates advanced imaging, intraoperative functional assessment, and patient-specific rehabilitation strategies. While robotic surgery has established a new benchmark for anatomic preservation hold promise for improving both oncologic and quality-of-life outcomes. Rigorous validation and standardized reporting will be critical to moving these innovations from investigational use into routine practice.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"63"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Next-Generation Nerve-Sparing Techniques in Robotic Radical Prostatectomy: A Contemporary Review.\",\"authors\":\"Brandon Piyevsky, Alina Gandrabur, Paige Bird, David I Lee, Mohammad Shahait, Ryan W Dobbs\",\"doi\":\"10.1007/s11934-025-01292-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>To summarize the evolution and future of technologies and techniques that assist in providing good functional outcomes during nerve-sparing robot-assisted radical prostatectomy.</p><p><strong>Recent findings: </strong>Recent data underscore the value of preoperative optimization, including structured weight loss and pharmacologic interventions such as GLP-1 receptor agonists, in facilitating safer and more precise nerve-sparing. Advances in imaging and surgical planning, including 3D modeling and augmented reality, have enhanced anatomic visualization and margin control. Intraoperative adjuncts such as frozen section analysis (NeuroSAFE), nerve mapping and fluorescence guidance are being evaluated to minimize neural injury. Next-generation robotic systems incorporating haptic feedback and intraoperative penile oxygen monitoring may provide real-time functional assessment. Early series suggest these technologies can improve early continence and potency recovery, though long-term validation is needed. The future of nerve-sparing prostatectomy lies in a precision-based, multimodal framework that integrates advanced imaging, intraoperative functional assessment, and patient-specific rehabilitation strategies. While robotic surgery has established a new benchmark for anatomic preservation hold promise for improving both oncologic and quality-of-life outcomes. 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Next-Generation Nerve-Sparing Techniques in Robotic Radical Prostatectomy: A Contemporary Review.
Purpose of review: To summarize the evolution and future of technologies and techniques that assist in providing good functional outcomes during nerve-sparing robot-assisted radical prostatectomy.
Recent findings: Recent data underscore the value of preoperative optimization, including structured weight loss and pharmacologic interventions such as GLP-1 receptor agonists, in facilitating safer and more precise nerve-sparing. Advances in imaging and surgical planning, including 3D modeling and augmented reality, have enhanced anatomic visualization and margin control. Intraoperative adjuncts such as frozen section analysis (NeuroSAFE), nerve mapping and fluorescence guidance are being evaluated to minimize neural injury. Next-generation robotic systems incorporating haptic feedback and intraoperative penile oxygen monitoring may provide real-time functional assessment. Early series suggest these technologies can improve early continence and potency recovery, though long-term validation is needed. The future of nerve-sparing prostatectomy lies in a precision-based, multimodal framework that integrates advanced imaging, intraoperative functional assessment, and patient-specific rehabilitation strategies. While robotic surgery has established a new benchmark for anatomic preservation hold promise for improving both oncologic and quality-of-life outcomes. Rigorous validation and standardized reporting will be critical to moving these innovations from investigational use into routine practice.
期刊介绍:
This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.