UCL Division of Surgery and Interventional Science


NeuroSAFE trial nominated for HSJ award

8 April 2019

Congratulations to Mr Greg Shaw and the NeuroSAFE team for being nominated as a finalist in the Health Service Journal value awards 2019.

The NeuroSAFE procedure 

Robotic-assisted laparoscopic prostatectomy (RALP)

Prostatectomy is the name for an operation that is used to remove the prostate to treat cancer which has not left the organ itself.  A robot system is used in order to allow the surgeon greater precision and dexterity whilst maintaining the recognised advantages of keyhole (also known as minimal access) surgery.  

What is the NeuroSAFE technique?

The NeuroSAFE procedure is designed to minimise side effects of the surgery without compromising cancer care.  RALP is associated with negative post-operative side effects on the strength of a man’s erections. This is because important nerves that go to the penis run microscopically close to the prostate and can be damaged or even removed in the process of removing all the cancerous prostate during RALP.  The NeuroSAFE technique promotes safe nerve sparing, which in turn can benefit patients’ post-operative recovery, especially their erectile function. The technique involves the microscopic examination of the prostate by a trained pathologist, during the operation, to see whether prostate cancer is touching the outer margin of the specimen, adjacent to the nerves. If it is not, the nerve on each side is left in place. If it is, the cancerous cells and the nerve is removed, but only where it is pathologically proven necessary. 

Why is NeuroSAFE needed? 

Whilst current RALP practices in the UK allows nerve spare in many instances, often the nerves surrounding the prostate are unnecessarily removed along with the gland.  The NeuroSAFE technique aims to identify those men in whom sacrifice of the nerves is necessary.

The NeuroSAFE trial will evaluate the value of the  NeuroSAFE technique in a single blinded, multi-centre, randomised controlled trial concentrating on safety and patient reported functional outcomes.  This will be the first NeuroSAFE clinical controlled trial in the world.