逆行松解神经血管束且保留Retzius间隙机器人辅助腹腔镜根治性前列腺切除术的技术要点（“大家泌尿网”观看手术视频）

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（天津医科大学第二医院泌尿外科，天津市泌尿外科研究所，天津 300211）

Technical points of Retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle

WANG Yong， LIU Zihao， LIU Yang， HUANG Hua， SHAO Yuan， NIU Yuanjie

（Department of Urology， The Second Hospital of Tianjin Medical University， Tianjin Institute of Urology， Tianjin 300211， China）

ABSTRACT：Retzius-sparing robot assisted radical prostatectomy （RS-RARP） can significantly improve the immediate urinary continence without increasing the positive rate of surgical margin.However， the learning curve is long， and fewer than 10% of the surgeons can master it.Therefore，we have optimized the procedures of RS-RARP， applying radical prostatectomy with retrograde release of neurovascular bundle to preserve it to the maximum extent.Urethral anastomosis can be performed with only one suture， which eliminates the need for Hem-o-lok and reduces subsequent complications.Our team routinely carries out this operation， and conlcudes that this surgical method can achieve good tumor control， good urinary continence， fast recovery of sexual function， few complications， and strong operability.This article details the key steps and operation experience of this technique.

KEY WORDS：prostate cancer；neurovascular bundle；retrograde release；robot-assisted radical prostatectomy；urethral anastomosis；Retzius-sparing

摘要：保留耻骨后间隙的前列腺癌根治术（RS-RARP）可以显著提高术后即刻尿控且不增加切缘阳性率。（剩余8334字）