MA-RARP (Modified Anterior Robot-Assisted Radical Prostatectomy)

Hello Everyone. I was diagnosed with prostate cancer on 3/12/2026. I have intermediate grade prostate cancer, PSA= 12.9, stage T3a, Gleason Score 3+4=7, Extracapsular Extension (3mm), PSMA PET/CT shows no signs of cancer beyond prostate. My Decipher Genetic Test scored .70.

Can anyone out there recommend a skilled surgeon that can perform an MA-RARP prostatectomy?

I am located in California and I am looking for a surgeon who is experienced at MA-RARP, Modified Anterior Robot-Assisted Radical Prostatectomy, a refined robotic surgery for localized prostate cancer that removes the prostate gland while prioritizing functional recovery. It builds on the standard anterior approach by incorporating techniques like no-clip methods and bladder neck preservation to protect key structures.

This approach preserves the Retzius space—anterior to the bladder—avoiding disruption of the prostatic plexus, intrapelvic fascia, pubic prostatic ligament, and detrusor apron. Surgeons access the prostate via a retropubic space entry using robotic systems like da Vinci, maintaining tumor control without compromising margins.

This is NOT RS-RARP, Retzius Sparing Robot-Assisted Radical Prostatectomy, where the point of entry is posterior.

Does this approach ring a bell out there? MA-RARP uses da Vinci robotic systems for precise retropubic access, avoiding full Retzius disruption unlike standard anterior RARP. Modifications include no-clip dissection, bladder neck preservation, and careful anterior exposure to protect neurovascular bundles and fascia.

I am having a challenge finding a surgeon that is skilled at MA-RARP because most urological surgeons are trained on the Standard Anterior approach (SA-RARP) and the acronym, MA-RARP, is not widely recognized.

MA-RARP is a strong "middle of the road" choice. MA-RARP strikes a good balance for my T3a prostate cancer (3 mm ECE, Gleason 3+4=7, PSA 12.9, Decipher 0.70). It gives better early urinary continence control than standard SA-RARP (48% continent day 1 vs 6%, 100% by 3 months) while keeping cancer clearance rates similar (11% PSM vs SA's 9%).

Am I in "LaLa Land" with this approach? Please enlighten me.

Thanks for everyone's support and information, Nelson Lee