Progress in pelvic anatomy from the viewpoint of radical prostatectomy

Abstract

The procedure of radical prostatectomy has changed rapidly since the introduction of laparoscopic and robotic surgery, which allows for clear, highly magnified visualization. The da Vinci surgical system enables three-dimensional visualization and makes use of instruments with seven degrees of freedom. Since its introduction, the use of robot-assisted radical prostatectomy has spread rapidly worldwide. However, adaptation to changes in surgical techniques using knowledge of classical pelvic anatomy has been difficult. In this report, we reviewed the progress in knowledge of pelvic anatomy, particularly regarding the cavernous nerves, prostatic fascia, Denonvilliers' fascia, endopelvic fascia, bladder neck and apex of the prostate, with regard to radical prostatectomy. © 2012 The Japanese Urological Association.