Article: Neurosafe radical prostatectomy (RP) procedure

Just read about this this morning. Definitely looks like a positive option for future PC victims. I wonder how long it will take to become a standard in the operating room.

That was an interesting article, But when I read “ If the examination suggests the tumor has been removed, the nerve-containing outer layer of the prostate can be left intact, reducing the patient’s risk of erectile problems,” it made me wonder why they did not do this with nerve sparing techniques and what the difference was.

OMG…what goes around comes around. This NEW procedure is decades old and honestly don’t know why it WASN’T being done before.
Removing “frozen sections” was THE standard of care for years - @retireddoc I am sure can comment - in cancer surgery. My wife’s residency 45 yrs ago involved her being present at many hours- long marathon surgeries since tissue had to be removed, sent to the path lab and read by the pathologist (get in line).
If it had malignant cells he would call the OR and say “keep going”….Don’t know why this common sense approach ended in most surgeries. Hate to think that time is money; or maybe the rise of chemo and radiation as mop-up modalities became more acceptable?
But, as a non surgeon layman it seems that if you have a tumor so discrete and displaced from the NV bundle, why not just do focal therapy and be done with it?
True, you won’t have actual post surgical pathology, but with built in margins they allow for treatment wider than the actual tumor.
What’s old….is new again!
Phil

wow Phil... you are always the smartest one in the room

NeuroSafe seems so inherently logical - getting path feedback in real time, when surgeons can take steps while still open if positive margins are detected - that I cant believe its not standard of care for all prostatectomies. Having said that, it appears that a couple leading prostate centers in Maryland and DC dont use it. Am I missing something? Who wants to know you have positive margins after you are all buttoned up?

Also, I keep hearing about Nomograms - which the centers I talk with locally dont use either. Their value is a bit more debatable, but again, dont these leading centers talk to each other about SOC procedures?

No, Stu, far from it. However, I do enjoy sharing whatever knowledge I might have with the group.
I’ve learned a lot by listening to the people on this forum and I look forward to learning even more from you one day. Best,
Phil