V08-04: Functional Anatomy Sparing Technique for Prostatectomy
Following dissemination of robotic-assisted laparoscopic prostatectomy, enhanced understanding of the periprostatic anatomy has led to improved techniques that spare structures critical to continence and potency. Here we describe our hybrid, accessible approach to radical prostatectomy which preserves functional pelvic anatomy with the goal of improving postoperative continence and potency while simultaneously maintaining oncologic principles.
The Functional Anatomy Sparing Technique for Prostatectomy (FAST-P) builds on the advantages of both the retzius-sparing and lateral approaches to robotic prostatectomy and eliminates some of the technical challenges presented by each. The technique was performed by a single surgeon, on consecutive patients. Early data on outcomes were recorded.
Eight patients underwent FAST-P. In all patients the procedure was completed as planned. No major perioperative complications occurred. One patient was pT3a with the remainder pT2c. Six patients had negative margins. Seven patients were immediately continent following catheter removal and, three of six preoperatively potent patients had immediate erections sufficient for intercourse.
We are encouraged by our early results. While limited by the small volume and case series nature, our results are a substantial change from our previous experience. Continued evaluation of our operative outcomes with objective measures are needed.