A high standing surgeon at a top German clinic informed me that during the DaVinci surgery they do a frozen fraction of nerves (neurosave If I'm not mistaken) and they quickly check them during the surgery to see if there are mets. Then they decide to remove the nerves or do a nerve sparing operation.
I might have made a mistake describing it, but how common is this practice and where can I learn more about it?
Has anyone heard about it?
It is common, but not everyone does it. I know Ash Tewari (NYC) does it. Nerve sparing is seldom complete, and even with complete nerve sparing, erectile function is severely compromised. About 35% of men getting nerve sparing surgery retain erectile function sufficient for penetration.
For continence and erectile purposes, isn't radiation more likely to produce positive results than is surgery?
Even surgery by the best surgeons?
Yes. He knows that. I shared the ProtecT results.
When they have removed the whole prostate it is inked and sprayed with liquid CO2 to freeze it. Then they cut it in slices which are examined by a pathologist looking for positive margins. The surgeon (and patient) waits for the result. If the pathologist reports a positive margin, a secondary resection is performed where they cut slightly wider to avoid a positive surgical margin (and nerves will then be removed).
The diagnostic accuracy is not necessarily extremely high and of course dependent on the pathologist’s knowledge and experience but the technique reduces the incidence of positive surgical margins.
What Gemlin_ already described is called Intra-operational frozen sections. It is not that straightforward though when having to do with nerves sparing. In my case, (went to Germany just for this) frozen sections showed a contained tumor, yet, both nerves were removed. Later, the pathology showed one infiltrated seminal vesicle. Before surgery, another very skilled surgeon had told me that he could try to save one nerve bundle. The one that operated on me removed both. It is a decision taken on the spot. It goes without saying that it takes much more effort for the surgeon to separate the prostate from the surrounding nerves while inflicting as less as possible damage to them. On the other hand there is no 100% confidence that a "contained" tumor is really contained. So, the question for me could had been whether the latter was cautious (even extremely cautious) vs wanted to return home early, or the former used the (hypothetical) single nerve sparing as a sales pitch. But this question is irrelevant for me as at the time of surgery I was 70 y.o. and being with my wife for almost half a century.
Surgery or Radiation? 
Prostate cancer diagnosis 2 weeks ago scheduled for surgery 
post prostatectomy psa
Big decisions regarding SRT and ADT for BCR
Robotic Assisted Prostate Cancer Surgery Video available
