Surgical Techniques During Prostate Removal Improve Sexual Function Recovery

Recent research from Cedars-Sinai Medical Center highlights the significance of specific surgical actions in enhancing the recovery of sexual function after prostate cancer surgery. A dedicated team analyzed hundreds of hours of surgical videos to establish a link between minute surgeon movements, termed "surgical gestures," and patient outcomes.

Surgical gestures refer to small, deliberate movements such as tissue cuts, instrument adjustments, or tissue retraction. Dr. Andrew Hung, a urologic surgeon and senior author of the study, explained that these gestures function like an alphabet, forming the complex 'language' of a surgical procedure. By studying videos of 157 patients undergoing robotic-assisted radical prostatectomy, the team identified particular gestures associated with better nerve preservation and subsequent sexual function recovery.

Radical prostatectomy remains the most common treatment for localized prostate cancer, especially with the prevalent robotic-assisted technique. During these procedures, preserving nerves responsible for sexual function is critical. The study suggests that procedures akin to peeling an orange—carefully separating the nerve 'peel' from the prostate 'fruit'—are vital in avoiding nerve damage.

One key finding was that excessive retraction, or stretching of the nerves to move them aside, correlates with poorer recovery of sexual function, likely due to nerve paralysis caused by pressure. Since sexual function recovery can take up to a year, linking these gestures to patient outcomes has been challenging until now, thanks to routinely recorded robotic surgeries.

This approach enables surgeons to objectively assess and improve their techniques. The ultimate goal is to create a library of effective surgical gestures that lead to better patient outcomes, leading to advances in surgical training and practice.

Experts believe that this method could transform surgical standards and training, ensuring more consistent and successful recovery of functions post-surgery. Building a data-backed understanding of core surgical actions offers promising potential to improve results across the surgical spectrum.

Source: https://medicalxpress.com/news/2025-05-surgical-gestures-prostate-linked-sexual.html