Game Changer or Gimmick? Evaluating the shift to Retzius Sparing

Victor C. LinTaiwan Moderator

Chit Sin LohMalaysia Moderator

Rajeev TPIndia Moderator Newer Advances in the Endourological Management of Stones – Have We Reached the Zenith

Aaron GohMalaysia Speaker Game Changer or Gimmick? Evaluating the shift to Retzius SparingRetzius-sparing radical prostatectomy (RS-RP) offers a significant functional advantage, particularly in terms of immediate continence recovery. Despite early skepticism, non-inferior oncological outcomes have been observed in our personal case series, supporting its wider adoption. However, many surgeons still perceive the transition from the conventional anterior approach as technically challenging. A practical way to bridge this gap is through the hood-sparing technique, which modifies the anterior approach to preserve anterior support structures while gradually introducing the anterior dissection plane in a more familiar sequence. One critical but often overlooked determinant of success is the role of the bedside assistant. In academic centres, assistants are usually well-trained fellows; in many other settings, assistance is limited to rotational nurses or junior trainees. A clipless RS-RP technique simplifies the assistant’s role, requiring mainly suctioning and instrument passage. Concerns regarding nerve injury can be addressed using pinpoint monopolar or low-power bipolar energy, which allows for precise dissection with minimal lateral thermal spread. This session will demonstrate the RS-RP technique in a semi-live format, highlighting steps to safely adopt it outside high-volume centres. With structured modifications and thoughtful case selection, the shift to RS-RP can be both practical and beneficial.