2271 KB38 KB2026Bizjak, JureGodec, MatjažHawlina, SimonRibarič, SamoRozman, Janezštevilka:1letnik:60str. 3-11DOI:10.17222/mit.2025.1461ISSN:1580-2949COBISSID_HOST:268184835URN:URN:NBN:SI:doc-HIRXZDOKenInštitut za kovinske materiale in tehnologijeMateriali in tehnologijeelectrical nerve stimulationelektrična stimulacija živcafiziološka merjenjaneurovascular bundlesphysiological measurementsrobot-assisted radical prostatectomyrobotsko asistirana radikalna prostatektomijaživčno žilni snopiMonitoring and evaluation of erectile function during robot-assisted radical prostatectomy| Spremljanje in ocenjevanje erektilne funkcije med robotsko asistirano radikalno prostatektomijo|To optimize the removal of cancerous prostate tissue, nerve-sparing robot-assisted radical prostatectomy (RARP) is commonly used. This technique aims to preserve the neurovascular bundles (NVBs), damage to which is a major cause of postoperative erectile dysfunction (ED). The primary goal of this study was to develop and assess a novel intraoperative NVB stimulation (NVBS) system designed to elicit penile erectile responses during RARP and assist in predicting postoperative erectile function (EF). The stimulation paradigm involved applying trains of rectangular and quasi-trapezoidal stimulating pulses (stimuli) to the apical, mid, and basal portions of the NVBs for approximately 60 s, both before and after the nerve-sparing dissection. The stimulation probe was developed with a consideration of nerve-stimulation models, NVB anatomy, and surgical constraints. Electrodes made of platinum were embedded in denture-grade material and mounted in a titanium housing. To evaluate the erectile responses, a multi-sensor probe was designed to monitor axial penile rigidity (ARIG), galvanic skin response (GSR), and glans temperature Tgp. Additionally, corpus cavernosum electromyography (CC-EMG) was recorded using surface and needle electrodes. Among five male patients enrolled, two showed noticeable CC-EMG activity, but none demonstrated a measurable increase in axial penile rigidity. The CC-EMG data were limited to short-term monitoring and could not be reliably analyzed in the time or frequency domains. In conclusion, although the stimulation protocol did not trigger measurable erectile responses, CC-EMG signals offered intraoperative insights into NVB integrity. This information may support more accurate predictions of erectile function recovery following RARPZa optimalno odstranitev rakavega tkiva prostate se pogosto uporablja robotsko asistirana radikalna prostatektomija (RARP) zohranjanjem `ivcev. Ta tehnika si prizadeva ohraniti nevrovaskularne snope (NVB), katerih po{kodba je eden glavnih vzrokovza pooperativno erektilno disfunkcijo (ED). Glavni cilj te {tudije je bil razviti in oceniti nov sistem za intraoperativnostimulacijo NVB, zasnovan za izzivanje erektilnega odziva med RARP in pomo~ pri napovedovanju pooperativne erektilnefunkcije (EF). Stimulacijski protokol je vklju~eval uporabo pravokotnih in kvazi-trapeznih elektri~nih impulzov, ki so biliaplicirani na apikalni, srednji in bazalni del NVB pribli`no 60 sekund, pred in po disekciji z ohranjanjem `ivcev. Stimulacijskasonda je bila zasnovana z namenom zadostiti modelom `iv~ne stimulacije, anatomiji NVB in kirur{kim omejitvam. Elektrode izplatine so bile vgrajene v material za zobne proteze in pritrjene v titanovo ohi{je. Za oceno erektilnega odziva je bila izdelanamultisenzori~na sonda, ki je merila aksialno togost penisa (ARIG), galvanski ko`ni odziv (GSR) in temperaturo glansa (Tgp).So~asno je bila z uporabo povr{inskih in igelnih elektrod izvedena tudi elektromiografija korpusa kavernozuma (CC-EMG).Med petimi vklju~enimi bolniki sta dva pokazala zaznavno CC-EMG aktivnost, vendar noben ni izkazal merljivega pove~anjaaksialne togosti penisa. CC-EMG podatki so bili omejeni na kratkotrajno spremljanje in jih ni bilo mogo~e zanesljivo analizirativ ~asovni ali frekven~ni domeni. ^eprav stimulacija ni spro`ila merljivega erektilnega odziva, so CC-EMG signali nudilidragocene intraoperativne informacije o integriteti NVB. Te informacije lahko prispevajo k natan~nej{i napovedi okrevanjaerektilne funkcije po RARPTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaInštitut za kovinske materiale in tehnologije