A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy
Purpose. To report on the feasibility of a new Laparoscopic Doppler ultrasound (LDU) technology to aid in identifying and preserving arterial blood flow within the neurovascular bundle (NVB) during robotic prostatectomy (RARP). Materials and Methods. Nine patients with normal preoperative potency an...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Prostate Cancer |
| Online Access: | http://dx.doi.org/10.1155/2013/810715 |
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| author | Ketan K. Badani Edan Y. Shapiro William T. Berg Sarah Kaufman Ari Bergman Chris Wambi Arindam RoyChoudhury Trushar Patel |
| author_facet | Ketan K. Badani Edan Y. Shapiro William T. Berg Sarah Kaufman Ari Bergman Chris Wambi Arindam RoyChoudhury Trushar Patel |
| author_sort | Ketan K. Badani |
| collection | DOAJ |
| description | Purpose. To report on the feasibility of a new Laparoscopic Doppler ultrasound (LDU) technology to aid in identifying and preserving arterial blood flow within the neurovascular bundle (NVB) during robotic prostatectomy (RARP). Materials and Methods. Nine patients with normal preoperative potency and scheduled for a bilateral nerve-sparing procedure were prospectively enrolled. LDU was used to measure arterial flow at 6 anatomic locations alongside the prostate, and signal intensity was evaluated by 4 independent reviewers. Measurements were made before and after NVB dissection. Modifications in nerve-sparing procedure due to LDU use were recorded. Postoperative erectile function was assessed. Fleiss Kappa statistic was used to evaluate inter-rater agreement for each of the 12 measurements. Results. Analysis of Doppler signal intensity showed maintenance of flow in 80% of points assessed, a decrease in 16%, and an increase in 4%. Plane of NVB dissection was altered in 5 patients (56%) on the left and in 4 patients (44%) on the right. There was good inter-rater reliability for the 4 reviewers. Use of the probe did not significantly increase operative time or result in any complications. Seven (78%) patients had recovery of erections at time of the 8-month follow-up visit. Conclusions. LDU is a safe, easy to use, and effective method to identify local vasculature and anatomic landmarks during RARP, and can potentially be used to achieve greater nerve preservation. |
| format | Article |
| id | doaj-art-0a5d163a3d07490396d6baf64446edd9 |
| institution | Kabale University |
| issn | 2090-3111 2090-312X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Prostate Cancer |
| spelling | doaj-art-0a5d163a3d07490396d6baf64446edd92025-02-03T06:44:37ZengWileyProstate Cancer2090-31112090-312X2013-01-01201310.1155/2013/810715810715A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical ProstatectomyKetan K. Badani0Edan Y. Shapiro1William T. Berg2Sarah Kaufman3Ari Bergman4Chris Wambi5Arindam RoyChoudhury6Trushar Patel7Department of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USADepartment of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USADepartment of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USADepartment of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USADepartment of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USADepartment of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USADepartment of Biostatistics, Columbia University College of Physicians and Surgeons, 722 West 168th Street, 6th Floor, New York, NY 10032, USADepartment of Urology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 11th Floor, New York, NY 10032, USAPurpose. To report on the feasibility of a new Laparoscopic Doppler ultrasound (LDU) technology to aid in identifying and preserving arterial blood flow within the neurovascular bundle (NVB) during robotic prostatectomy (RARP). Materials and Methods. Nine patients with normal preoperative potency and scheduled for a bilateral nerve-sparing procedure were prospectively enrolled. LDU was used to measure arterial flow at 6 anatomic locations alongside the prostate, and signal intensity was evaluated by 4 independent reviewers. Measurements were made before and after NVB dissection. Modifications in nerve-sparing procedure due to LDU use were recorded. Postoperative erectile function was assessed. Fleiss Kappa statistic was used to evaluate inter-rater agreement for each of the 12 measurements. Results. Analysis of Doppler signal intensity showed maintenance of flow in 80% of points assessed, a decrease in 16%, and an increase in 4%. Plane of NVB dissection was altered in 5 patients (56%) on the left and in 4 patients (44%) on the right. There was good inter-rater reliability for the 4 reviewers. Use of the probe did not significantly increase operative time or result in any complications. Seven (78%) patients had recovery of erections at time of the 8-month follow-up visit. Conclusions. LDU is a safe, easy to use, and effective method to identify local vasculature and anatomic landmarks during RARP, and can potentially be used to achieve greater nerve preservation.http://dx.doi.org/10.1155/2013/810715 |
| spellingShingle | Ketan K. Badani Edan Y. Shapiro William T. Berg Sarah Kaufman Ari Bergman Chris Wambi Arindam RoyChoudhury Trushar Patel A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy Prostate Cancer |
| title | A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy |
| title_full | A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy |
| title_fullStr | A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy |
| title_full_unstemmed | A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy |
| title_short | A Pilot Study of Laparoscopic Doppler Ultrasound Probe to Map Arterial Vascular Flow within the Neurovascular Bundle during Robot-Assisted Radical Prostatectomy |
| title_sort | pilot study of laparoscopic doppler ultrasound probe to map arterial vascular flow within the neurovascular bundle during robot assisted radical prostatectomy |
| url | http://dx.doi.org/10.1155/2013/810715 |
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