SAFE Technique for Improved Outcomes in Robot-Assisted Prostatectomy

What is it about?

This study aimed to evaluate the impact of the Saline-Assisted Fascial Exposure (SAFE) technique on erectile function (EF), urinary continence, and oncological outcomes after Robot-Assisted Laparoscopic Radical Prostatectomy (RALP). The SAFE technique improves Sexual Health Inventory for Men (SHIM) scores at 6, 13, 26, and 52 weeks after surgery compared to the standard RALP technique. The study included patients with a baseline SHIM score of ≥17 and a high probability of extracapsular extension (ECE), ranging from 21% to 73%, as per the Martini et al. nomogram. The SAFE technique was performed using two approaches, transrectal guided by micro-ultrasound or transperitoneal. The study found that the baseline SHIM score and use of the SAFE technique were independent predictors of EF recovery. The urinary continence rates for the RALP + SAFE group were observed to be earlier, but this result was not statistically significant. The SAFE technique is a practical and easy technique to implement in clinical practice, facilitating an atraumatic dissection of the neural hammock as well as the visualisation of the periprostatic nerves. [Some of the content on this page has been created by AI]

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Why is it important?

This research is important because it provides initial experience and assessment of the impact of the Saline-Assisted Fascial Exposure (SAFE) technique on erectile function, urinary continence, and oncological outcomes after Robot-Assisted Laparoscopic Radical Prostatectomy (RALP). The study focuses on patients at high risk of extracapsular extension (ECE) who underwent a partial neurovascular sparing (NS) procedure, and it shows that the SAFE technique leads to better sexual health inventory (SHIM) scores and continence rates compared to the standard RALP technique. Key Takeaways: 1. The SAFE technique is a practical and easy technique to implement in clinical practice, facilitating an atraumatic dissection of the neural hammock and visualization of the periprostatic nerves. 2. The SAFE technique improves SHIM scores at 6, 13, 26, and 52 weeks after surgery compared to the standard RALP technique. 3. The SAFE technique is safe and does not increase the risk of postoperative SHIM scores. 4. Prospective randomized trials are needed to further validate the results.