Radical Prostatectomy

For Robotic Radical Prostatectomy see this page.

 

Anatomical Landmarks

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Bladder Neck Sparing

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Nerve Sparing

 

“On Feb 13, 1981 Pieter Donker and I identified the location of the cavernous nerves in an infant cadaver.  Our observation was very important, because we identified their location outside the prostate​. At that time everyone believed that the nerves ran through the prostate because all men were impotent following surgery.  We demonstrated that this was incorrect, but the next question was how to find these microscopic structures in the adult male pelvis during surgery.  During a radical prostatectomy in October 1981 I noticed that the capsular arteries and veins of the prostate travelled in the same location as the cavernous nerves in the fetus. Based on these findings I speculated that the neurovascular bundle could be used intraoperatively and on April 26, 1982 I performed the first operation utilizing this concept.  That patient is cancer free today having lived a normal life.  For more information see  Walsh PC. The discovery of the cavernous nerves and development of nerve sparing radical retropubic prostatectomy. J Urol 2007;177:1632-5.​  I hope this is helpful.Patrick Walsh (Original Drawing)

 

 

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The ‘Net’!

 

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Santorini’s Management – The Urethra

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Posterior Reconfiguration

 

Rocco Stitch – Original Drawing by Francesco Rocco

 

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The situation at the end of prostatectomy!

 

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Pelvic Lymph Node Dissection

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