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Fernández De la Maza S, Conrad S, Graefen M, et al. Early clinical experience with water-jet dissection (hydro-jet) during nerve-sparing radical retropubic prostatectomy. Minim Invasive Ther Allied Technol. 2002;11(5):257-264doi: 10.1080/13645706.2003.11873723.
Fernández De la Maza, S., Conrad, S., Graefen, M., Noldus, J., & Huland, H. (2002). Early clinical experience with water-jet dissection (hydro-jet) during nerve-sparing radical retropubic prostatectomy. Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy, 11(5), 257-264. https://doi.org/10.1080/13645706.2003.11873723
Fernández De la Maza, S, et al. "Early clinical experience with water-jet dissection (hydro-jet) during nerve-sparing radical retropubic prostatectomy." Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy vol. 11,5 (2002): 257-264. doi: https://doi.org/10.1080/13645706.2003.11873723
Fernández De la Maza S, Conrad S, Graefen M, Noldus J, Huland H. Early clinical experience with water-jet dissection (hydro-jet) during nerve-sparing radical retropubic prostatectomy. Minim Invasive Ther Allied Technol. 2002 Jan;11(5):257-264. doi: 10.1080/13645706.2003.11873723. PMID: 28561612.
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Minim Invasive Ther Allied Technol. 2002 Jan;11(5):257-264. doi: 10.1080/13645706.2003.11873723.

Early clinical experience with water-jet dissection (hydro-jet) during nerve-sparing radical retropubic prostatectomy.

Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy

S Fernández De la Maza, S Conrad, M Graefen, J Noldus, H Huland

Affiliations

  1. a Department of Urology , University Hospital Hamburg - Eppendorf , Hamburg , Germany.

PMID: 28561612 DOI: 10.1080/13645706.2003.11873723

Abstract

Successful preservation of the neuro-vascular bundle (NVB) during anatomical nerve-sparing radical retropubic prostatectomy (NS-RRP) for patients with clinically localized prostate cancer is a great operative challenge. We employed a new dissection method using water-jet technology for the preservation of the NVB. We evaluated intraoperative parameters, complications and early functional results regarding continence and potency. The results were compared to a conventional operative technique. Bilateral NS-RRP was performed by the same urologist in 36 consecutive cases between January and December 2000. Eighteen patients underwent NS-RRP using water-jet dissection (ERBE Helix Hydro-Jet). Eighteen patients underwent a standard NS-RRP. Water-jet dissection was used exclusively for nerve-sparing. We assessed blood loss, operation time, complications and incidence of blood transfusions. Early continence and potency rates were evaluated. Nerve-sparing using the Hydro-Jet technique appeared to be easier, more subtle and faster compared with the standard surgical technique. The exact dissection of the layers allowed a selective dissection and better control of crossing vessels to the prostate. Blood loss was reduced by 36% (p=0.02), no blood transfusion was necessary and the operation time was reduced by 20% (p=0.02). There were no major complications. Continence rates 3 months after RRP were 77.7% in the water jet group and 66.6% in the standard group, and overall potency rates (any grade of erection) were 77.7% and 55.5% respectively. Water-jet dissection is a feasible, safe and efficient technique to facilitate NS-RRP. There is a minimal learning curve with comparable functional results to the conventional procedure. Further improvements in the water-jet application and a longer follow-up might lead to further improvements in continence and potency rates in patients undergoing NS-RRP.

Keywords: hydrodissection; prostate cancer; radical prostatectomy; water-jet

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