Prostate cancer is the most common cancer in men. Radical prostatectomy is an established curative treatment and is now predominantly performed with robotic assistance. A key goal of the procedure is to preserve the neurovascular bundles, which are essential for erectile function and urinary continence. Two standard techniques are available for haemostasis during nerve-sparing dissection: athermal control using surgical clips and electrocautery. To date, high-quality prospective evidence on which technique leads to better functional outcomes is lacking. Concerns include thermal nerve injury caused by electrical energy as well as clip-related tissue effects.

The randomised controlled CLIPLESS trial investigates the feasibility of a direct comparison of both techniques. The primary endpoint is the change in erectile function twelve months after surgery. In addition, urinary continence, quality of life, perioperative complications and oncological outcomes are assessed. The study thus lays the foundation for optimising the surgical technique.