ProPep Surgical Information

Nerve sparing during radical prostatectomy has traditionally focused on preservation of the parasympathetic nerves located within the NVB that are responsible for the vascular/filling phase of the erectile response. Studies have shown, however, that a somatic nerve (the muscular branch of the perineal nerve), not located within the NVB and found in highly variable locations around the apex of the prostate, drives the muscular phase of the erectile response. This nerve is responsible for the achievement of the full tumescence and rigidity needed for penetration. Using the ProPep® Nerve Monitoring Device, surgeons have demonstrated the ability to accurately, safely, and efficiently identify this critical nerve branch during RARP. The variability in the location of this nerve and the perineal nerve, the inability to predict their location based on anatomic landmarks, and the fact that both nerves are often located outside of the traditional NVB makes the use of the ProPep® Nerve Monitoring Device essential in identifying these non-visible somatic nerves to avoid surgically induced trauma during the pedicle and apical dissection. Critical points during the procedure where somatic nerves are at risk - Wide excision -Posterior dissection -Pedicle dissection -Apical dissection -Posterior reconstruction -Anastomosis Once in place, the system helps the surgeon: - Identify the location and assess the integrity of non-visible nerves critical to urinary control and sexual function prior to prostate removal - Verify the location and integrity of these nerves throughout the surgery - Validate the integrity of the nerves after prostate removal