الفهرس 
Development of the surgical robotsOnly 14 pages are availabe for public view
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Abstract
The nerve sparing radical prostatectomy is the gold standard management for young patients with organ confined prostate cancer achieving earlier urinary continence and potency, however higher rates of positive surgical margin could be associated with bilateral nerve sparing and appropriate selection of patients for nerve sparing is mandatory.
RALRP had revolutionized the nerve sparing radical prostatectomy, allowing for better delineation of the fascial planes for dissection of the NVB and qualifying the different grades of nerve sparing.
NSRALRP is safe and associated with better perioperative outcomes; shorter hospital stay, lesser need for blood transfusion and less perioperative complication and bilateral lymphadenectomy can be carried out in the setting of the NSRALRP without significant increase in perioperative morbidity.
PSMs are influenced by patient´s related parameters e.g preoperative PSA, BMI and prostate volume; operative parameters e.g state of nerve sparing, surgeon ´s experience and fascial planes for dissection of NVB; and tumor related parameter e.g pathologic tumor stage and location of the tumor.
As regards the quality of life, patients undergoing NSRALRP achieve high functional and low symptom scores after the operation almost similar to baseline quality of life 12 months after NSRALRP. The postoperative quality of life for these patients was similar or higher to that of matched age groups in the general population.
Urinary continence after RALRP could be influenced by the state of nerve sparing, however many factors contributes to the early recovery of urinary continence and affect the rates of continence reported after the RP e.g preoperative patient characteristics, surgeon experience, surgical techniques, and methodological aspects such as continence definitions, tools used for data collection, and different follow-up intervals.
The 12-months recovery urinary continence rates were better with the robotic assisted surgical approach compared with the retropubic and laparoscopic approaches decreasing the absolute risk for postoperative urinary incontinence. Recent studies demonstrated that higher grades of nerve sparing are associated with better rates of urinary continence.
RALRP is associated with earlier recovery of sexual function and better potency rates compared with the RRP and LRP, however different patient´s related parameters (age, preoperative potency and comorbidity index) and operative related parameters (quality of nerve sparing, countertraction and thermal dissection) as well as definition used, time of postoperative evaluation and method for reporting of postoperative potency could highly influence these rates.
Finally, NSRALRP demonstrated also non–statistically significant differences in PSM rates and biochemical recurrence free survival compared with RRP and LRP.