Intrafascial nerve-sparing endoscopic extraperitoneal radical prostatectomy.

OBJECTIVES To present a modification of our previously published technique of nerve-sparing endoscopic extraperitoneal radical prostatectomy (nsEERPE). METHODS The technique enables puboprostatic ligament preservation, leaving intact the puboprostatic ligaments, endopelvic fascia, periprostatic fascia, and neurovascular bundles (intrafascial dissection). The modification of nsEERPE was performed in 50 consecutive patients. RESULTS The total operative time was 131 minutes (range 75 to 165). The mean catheterization time was 5.4 days (range 5 to 14). CONCLUSIONS The intrafascial nsEERPE is a modification of our previously published standard nsEERPE. The anterior approach to the periprostatic fascia enables less traumatic dissection from the prostate and thus, theoretically, a more viable neurovascular bundle.