Multiple approaches on a high fidelity surgical model for robot-assisted nerve-sparing radical prostatectomy training

Introduction Robot-assisted radical prostatectomy (RARP) with nerve-sparing is technically demanding and requires mastery of different surgical approaches to preserve functional outcomes while maintaining oncological control. This video demonstrates the feasibility of performing three approaches—anterior, anterior with Hood technique, and posterior—using a high-fidelity inanimate pelvic model. Methods All procedures were performed on the Urotrainer® VP model with a da Vinci® robotic surgical system in a dry-lab environment. The model replicates prostate, bladder, seminal vesicles, urethra, neurovascular bundles and planes with life-like tissue properties. Each approach was demonstrated step-by-step, emphasizing dissection planes and nerve preservation. Vesicourethral anastomosis was also performed, allowing multiple repetitions of the reconstructive step. Results The model enabled realistic simulation of anterior, Hood, and posterior nerve-sparing approaches. Fascial planes and neurovascular bundles were consistently identified, and dissection could be performed with lifelike tactile feedback. While resection steps were limited to one per model, the anastomosis was repeatable, providing opportunities for additional practice. Conclusion This high-fidelity inanimate model facilitates demonstration and training of multiple nerve-sparing approaches in RARP. Its anatomical fidelity and capacity for reconstructive repetition highlight its value as an educational tool in robotic surgery training programs.