AUSTIN -- Doctors are making great strides in robotic prostate surgeries, but research shows urinary incontinence remains a troubling side effect.
Fifty percent of all patients still have that problem three months after surgery. Nearly 20 percent are still suffering incontinence issues a year after surgery. New technology developed in Austin may help reduce that side effect significantly.
Inside an operating room at St. David's South Austin's Medical Center, urologist Peter Ruff performed a robotic prostate surgery. The purpose is to rid the patient of cancer, but it can result in side effects.
"The two major side effects to a prostatectomy are urinary incontinence or leaking urine and erectile dysfunction after the surgery," said Ruff. "The nerves that control both of those functions live right on the surface of the prostate."
Identifying exactly where those nerves are has been a problem. Even with the da Vinci's magnification that's 10 times that of the human eye, doctors could only guess on the nerve's location.
"In essence we knew anatomically where they're supposed to be, but we couldn't see them," said Ruff.
They couldn't seem them until now. ProPep Surgical's Nerve Mapping Technology -- developed in Austin -- has helped take the guess work out of nerve location. Tiny amounts of electricity are used to stimulate the nerves, showing surgeons where they are.
"We still don't technically see the nerves," said Jon Schiff, the ProPep Surgical Nerve Mapping Inventor. "What we do is we electrically stimulate them with an instrument he's already using. So if we can electrically stimulate it to get a response, then we know that's the nerve."
ProPep surgical reps are on hand during surgery. What they see on their monitors is sent directly to the surgeon's da Vinci robot screen.
"When he touches a nerve with his instrument, he touches a nerve right there," said Schiff. "It makes is very, very easy and user friendly to identify the nerves that way."
Doctor Ruff says it's another advancement that is helping to make a delicate operation less stressful to the patient.
"It was a good operation," said Ruff. "We're making it even better."
"I feel pretty proud to be a part of this whole process," said Schiff. "It's nice to know that we contributed to the quality of life for patients down the line."
Ruff says the Nerve Mapping Technology has helped surgeons realize there can be as much as a full centimeter difference in nerve location from patient to patient. That may not sound like much, but he says when you're dealing with microscopic nerves, it's significant.
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