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The preservation of sexual potency after radical prostatectomy has always been the topic of much anxiety and debate. While cancer control and urinary continence are of supreme importance, the preservation of sexual function completes the trifecta that both patient and surgeon strive to achieve. The introduction of robotic assistance to modern laparoscopic surgery has provided many advantages, the two greatest being improved three-dimensional magnified vision and wristed instrumentation. These technical enhancements provide the surgeon with improved surgical tools that have the potential to facilitate a more precise surgical approach. One of the potential advantages during robot-assisted laparoscopic prostatectomy (RALP) is improving visualization, control, and dissection of the neurovascular bundle (NVB). With this article, we provide the description of our current technique of intrafascial, tension and energy-free dissection of the NVB during RALP, aiming to maximize the preservation of the periprostatic neuronal network and improve erectile function outcomes. A step-by-step description of the preservation of the pubovesical complex is also provided. [ABSTRACT FROM AUTHOR]

The article offers step-by-step instructions for conducting laparoscopic extravesical ureteric re-implantation.

The article presents a case study of a 44-year-old French man who was diagnosed with right hydronephrosis with the existence of retrocaval ureter obstruction. It says that the patient has a history of flank pain on the right side. It mentions that the patient underwent laparoscopic dismembered pyeloplasty, wherein he was in flank position during the surgery. It adds that zero obstruction on the right kidney of the patient has been revealed by renal scan after 12 months of follow-up examination.

Abstract: Background: Puboprostatic ligament preservation has been proposed as a method to accelerate continence recovery after radical prostatectomy (RP). However, these ligaments present anatomic continuity with the bladder, and there must be interruption at some point to expose the prostatourethral junction. Objectives: To describe the surgical steps of pubovesical complex (PVC)–sparing robot-assisted laparoscopic RP (RALP) and present the preliminary results of our technique. Design, setting, and participants: Thirty PVC-sparing RALP procedures were performed in patients <60 yr with clinically localised prostate cancer between 2007 and 2009 by the same surgeon. Surgical procedure: The principles of bladder neck preservation, tension and energy-free dissection of the bundles as well as seminal vesicle sparing are applied. Ventrally, a plane of dissection is developed between the detrusor apron and the prostate. The soft connective tissue between Santorini''s plexus and the prostate is blandly dissected, leaving the plexus intact and in place. Measurements: The rates and location of positive surgical margins (PSM) as well as functional outcomes are presented. Results and limitations: Three of 30 patients (10%) had a PSM (two apical margins and one on the left posterolateral side). At catheter removal, 24 of 30 patients (80%) were dry (0 pads), and 6 of 30 patients (20%) needed one security pad. After 3 mo, 22 of 30 patients (73%) presented an International Index of Erectile Function score >17 (with or without phosphodiesterase type 5 inhibitors). Thirteen of 22 potent patients had an Erection Hardness Score of 3, and 9 of 22 patients had a score of 4. Small sample size, low mean age of enrolled patients (52 yr), and the absence of diseases that could impair the continence and potency recovery are some of the limitations of the study. Moreover, it is difficult to quantify the effect of each applied continence-sparing technique. Conclusions: The holistic preservation of the PVC during RALP is technically feasible. It leads towards an absolute preservation of the periprostatic anatomy that may enhance early functional outcomes. Further studies are needed to confirm our results. [Copyright &y& Elsevier]

The article focuses on the surgical steps in laparoscopic treatment of benign prostatic hyperplasia (BPH). It says that BHP is one of the most common diseases in ageing men and could be associated with lower urinary tract symptoms (LUTS). It presents the steps in laparoscopic treatment of BPH such as extraperitoneal space development and trocar placement and adenoma dissection and distal urethra incision. Moreover, it discusses the advantages and the drawbacks of laparoscopic approach.