Step 5. Incremental nerve sparing A. Mottrie

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Step 5. Incremental nerve sparing

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Information

                                    Title: 
                                    Step 5. Incremental nerve sparing
                                
                                    Author: 
                                    
                                            Alex Mottrie                                        
                                    
                                    Date:
                                    18-08-2016

Description

The anterior release divides fascial layers down to the surface of the prostate (depending on the nerve sparing grade)
The pedicles are divided using hem-o-locks
5 mm clips can be used to control small vessels close to the neurovascular bundles
The dissection is then continued on the posterior surface of the prostate
A blunt dissection should ideally be performed. Cutting might be necessary to define the correct plan and to reduce the risk of positive margins
In case of locally advanced or bulky disease an extrafascial dissection represents a safe approach from an oncologic standpoint

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