Deerush Kannan Sakthivel1, Pushan Prabhakar2, Mohamed Javid Raja Iyub2, Manuel Ozambela Jr2, Murugesan Manoharan2
1 Department of Urology, Baptist Health South Florida, Miami, USA; 2 Department of Urology, Baptist Health South Florida, Miami, USA
J Robot Surg. 2025 Oct 22;19(1):707.
DOI: 10.1007/s11701-025-02880-7 | ACCESS: 41125940
COMMENT
IRobotic surgery has revolutionized the surgical treatment of prostate cancer, resulting in better outcomes and faster recovery ( 1 – 4 ). One of the most important aspects for the technical refinement of this surgical procedure is knowledge of pelvic anatomy. In tis paper of Sakthivel and collegues ( 5 ) we can observe the importance of the anatomy specially in large prostates. The authors described the maximal anatomic bladder neck preservation at the prostatic origin (MANO) technique, designed to enable safe circumferential dissection at the true bladder neck origin irrespective of gland size and concluded that larger prostates were associated with older age and higher preoperative, mean operative time increased with gland size and hospital stay was longer for > 50 cc prostates. The authros shows that the MANO technique enables safe bladder neck preservation across all prostate sizes. Despite increased operative complexity in larger glands, functional and oncological outcomes remain equivalent. This approach may standardize bladder neck management in RALP and support improved continence recovery irrespective of prostate volume. We congratulate the authors for the interesting paper.
Data Availability
Uninformed
REFERENCES
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Associated Data
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Data Availability Statement
Uninformed