Researchers are being tested a nerve detector as a means to reduce nerve injury during surgery. The nerve-spotter functions like a mine-sweeper that detects the site of vital nerves buried in the tissue and which are invisible to the eye. It facilitates surgeons to avoid accidentally severing them.
Now, surgeons are trailing the nerve-detector in prostate surgery in order to decrease post-operative incontinence and impotence. About thirty percent of prostate cancer patients experience some degree of erectile dysfunction subsequent to a prostatectomy. This typically occurs as a result of damage to two sets of nerved adjacent to the prostate gland.
One set of nerves controls sexual functioning while other controls continence. Usually these side-effects are temporary, but in about twenty percent of sufferers, these side-effects could last for two years or longer. At present surgeons rely on anatomical signposts such as the seminal vesicles and their judgment. Seminal vesicles are tiny sacs at the back of the prostate gland.
But the new device, known as the ProPep Nerve Monitoring System, helps the surgeon to monitor the position of the nerves. In this monitoring system two wire-like electrodes are placed in the tissue around the prostate and urethra. These electrodes are connected to an external monitor. The electrodes emit a small electrical current.
The speed at which this current passes through the tissue shows if there is a nerve there. Because, nerves different from tissue, are highly efficient carriers of electricity. When nerves are detected, the electrodes make a special type of warning signal, displayed on the monitor for the surgeon to see during the operation.
Nerve monitoring system is already used in some spinal and brain operations. But for the first time the device is created for prostate procedures. Prof Raj Persad, urological surgeon at the Bristol Royal Infirmary and Bristol Urological Institute, commenting on the device, stated it has potential for enhancing the quality of life of thousands of men, who have this procedure every year.
Surgeons welcome anything that will help pinpoint the nerves to give better outcomes for sexual function and continence. This one is made for the robot, which is increasingly the method by which prostate surgery is performed but it can be used during open surgery as well, concluded Prof Persad. The ProPep has now been approved for use in the UK.