A subsidiary of the University Medical Center Hamburg-Eppendorf

Vom 24.06.2024 bis 01.07.2024 zieht unsere Klinik in ein neues Gebäude. In diesem Zeitraum sind wir nur eingeschränkt erreichbar. Vielen Dank für Ihr Verständnis.
Operationsteam konzentriert bei einer OP

Special surgical techniques at the Martini-Klinik

Removing the prostate while preserving the patient’s potency and sparing the urinary sphincter entirely is the goal of every radical prostatectomy. At the Martini-Klinik, we place special emphasis on achieving this goal. Special surgical techniques preserve patients’ continence and potency at same level as before the operation in the majority of cases.

We apply these surgical techniques in both surgical methods – in conventional open surgery as well as in robotic-assisted surgery, such as using the da Vinci system.

Preserving potency with special urethral dissection

When it comes to the potential side effects of radical prostatectomy, patients are generally most concerned about incontinence. To prevent it from occurring, we have developed the full-functional length urethra (FFLU) technique, which makes it possible to maintain to fully preserve the function of the urethral sphincter. It involves dissecting the urethra in a way that preserves the full functional length of the urethral sphincter before reconstructing its proper anatomic fixation within the pelvic floor. 

This procedure can achieve a significant improvement in early continence and the majority of patients regain control of their bladder soon after the operation. 

Martini-Klinik

Accompanies you through this topic

Dr. Uwe Michl
Faculty member

Martini-Klinik

The prostatectomy

How is the prostate removed? And how are continence and potency maintained if oncologically possible. A short explanatory film.

4.08 minutes

Preserving potency through intraoperative fresh-frozen section analysis

The prostate is directly surrounded by vital functional nerve tissue. This delicate nerve bundle controls erections and is therefore needed to preserve potency. If it is possible to spare this delicate neurovascular structure during surgery by carefully separating it from the prostate, millimetre by millimetre, erectile function can be preserved in the vast majority of cases. 

At present, no procedure has been developed that can provide this crucial information before surgery with a degree of precision that meets our standards for patient safety. It is certainly not possible to detect the spread of a tumour into the neurovascular bundles with the naked eye with any degree of certainty.

Fresh-frozen section analysis the Martini-Klinik NeuroSAFE technique

In order to spare the patient’s nerves during surgery and therefore preserve their potency, the Martini-Klinik has developed a procedure to fully investigate the removed prostate’s contact surfaces with the neurovascular bundle. This intraoperative fresh-frozen section analysis helps surgeons make decisions during surgery and is known as the NeuroSAFE technique. Once the prostate has been removed, the surgeon removes the edges of the organ in the operating theatre. This tissue immediately undergoes microscopic analysis at the University Medical Centre Hamburg-Eppendorf’s Institute of Pathology, which specialises in prostate cancer. Around 30 minutes later, the pathologist telephones the surgeon with the results. If the edges of the prostate are tumour-free, the neurovascular bundles can be preserved. However, if cancer cells are detected in these areas, parts of the affected neurovascular bundle must be removed during the remainder of the operation to treat the tumour effectively. Thanks to the NeuroSAFE technique, only the nerve tissue actually affected by the tumour is removed. Healthy tissue can be safely left untouched. 

At the Martini-Klinik, the NeuroSAFE technique enables us to operate successfully on over 98% of all tumours localised in the organ while sparing the nerves – a figure few other clinics around the world can match.

Facts about continence and potency in patients at the Martini-Klinik
A specialist medical description of the FFLU surgical technique

Intraoperative fresh-frozen section analysis makes it possible to identify when a tumour extends beyond the capsule, which may have gone undetected in diagnostic procedures, and remove the affected tissue. 

Prof. Dr. Markus Graefen

What special surgical techniques are there for prostate cancer?

Removing the prostate while preserving the patient’s potency and sparing the urinary sphincter entirely is the goal of every radical prostatectomy. At the Martini-Klinik, we place special emphasis on achieving this goal. Special surgical techniques preserve patients’ continence and potency at same level as before the operation in the majority of cases.