In 2007, more than 200,000 men were newly diagnosed with prostate
cancer, with many of them undergoing radical prostatectomies. During a
radical prostatectomy, care is taken to remove the cancer and the
prostate while preserving the surrounding nerves. The cavernous nerves,
which lie next to the prostate, are essential for erectile function, and
to a lesser degree, urinary continence.
Dr. Kevin Slawin and Dr. Tung Shu, founders of the new Vanguard Urologic
Institute in Houston, TX, have been at the forefront of developing
minimally invasive techniques using the da Vinci System to perform
radical prostatectomies in patients with prostate cancer while
minimizing damage to the surrounding tissues. Their results confirm
excellent cancer control rates, equivalent to the standard open approach
to radical prostatectomy, accompanied by a decreased length of stay, and
decreased morbidity as measured by a more rapid recovery of both potency
and continence.
However, when the cancer has spread beyond the prostate, oftentimes one
or both of the cavernous nerves have to be partially or completely
removed in order to improve the chances of achieving a “negative
surgical margin” indicating complete removal
of the cancer. Typically, these nerves are left unrepaired. However,
institutions like the Vanguard Urologic Institute are offering nerve
grafting to repair these nerves at the time of prostatectomy, thus
providing patients with prostate cancer an increased hope of having
sexual potency after the procedure.
The Vanguard Urologic Institute is the first center in the US to use
AxoGen's Avance Nerve Grafts to repair the cavernous nerves
robotically. Since their first case in January 2008, they have performed
both unilateral and bilateral cavernous nerve repairs.
“We have previously published our results
demonstrating the improved outcomes with respect to both continence and
potency in men who require neurovascular bundle resection, either
unilateral or bilateral, who undergo sural nerve graft procedures at the
time of their initial surgery. The availability of Avance Nerve Graft
now allows us to perform this procedure without removing autologous
sural nerve from the patient, which is associated with loss of sensation
and even occasional pain at the donor site. The ease of handling and the
superior length of Avance Nerve Graft has made it the preferred graft
material for our doctors when performing cavernosal nerve graft
reconstruction in men undergoing prostatectomy for locally advanced
disease,” states Dr. Kevin M. Slawin,
Director, Vanguard Urologic Institute and the Texas Prostate Center.
Avance Nerve Graft allows injured peripheral nerves to be repaired using
allograft nerve; thus, enabling axon regrowth and eventual restoration
of sensation and function to those effected nerves. Avance Nerve Graft
is a breakthrough in nerve technology. It provides an environment for
nerve fiber regeneration by having a biological support structure with
inherent growth promoters. Avance Nerve Graft is decellularized,
enabling guided nerve regeneration without immunosuppression.
“At the Vanguard Urologic Institute, we are
constantly looking for new technologies that can help us improve the
care we provide our patients. Avance Nerve Graft has allowed us to
capture the benefits of nerve grafting in select cases undergoing
radical prostatectomy while eliminating the potential side effects of
using autologous sural nerve for the graft,”
says Dr. Tung Shu, Director, Endourology and Minimally Invasive Surgery
at the Vanguard Urologic Institute.
About Doctors at Vanguard Urologic Institute
The Doctors at the Vanguard Urologic Institute is located in Houston,
TX. “Vanguard” is
defined as “any creative group active in the
innovation and application of new concepts and techniques, and occupying
the position of greatest advancement or leading position in any given
field”. Consistent with their name, the
mission of the Vanguard Urologic Institute is to embrace new ideas and
technologies in science and medicine, bringing the best of them to their
patients.
Visit The Doctors at the Vanguard Urologic Institute at: www.vanguardurology.com
About AxoGen, Inc.
AxoGen, Inc., founded in 2002 and based in Alachua, Florida, is a
privately held company pioneering the commercialization of peripheral
nerve grafting and nerve regeneration technologies. AxoGen is focused on
the advancement of peripheral nerve repair by developing superior
technologies for surgeons to help patients with peripheral nerve
injuries.
Visit AxoGen at: www.axogeninc.com
Avance Nerve Graft is a registered trademark of AxoGen,Inc.
da Vinci System is a registered trademark of Intuitive Surgical.
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