Bladder neck dissection during a robot-assisted radical prostatectomy
Case specifics:
- Robot-assisted radical prostatectomy—focus on the bladder neck dissection
- Completed in 2020, Ottawa, ON, Canada at the The Ottawa Hospital.
- Equipment: Da Vinci, Xi
- Disease: pT1c, Gleason 4+3 prostate cancer.
Legend for video:
- Blue circle/arrow = visual cues and landmarks
- Purple arrow = maneuver
Learning objectives:
- Conceptualize the steps of the bladder neck dissection
- Describe 3 visual cues that could indicate incision into prostatic tissue
- Describe 3 maneuvers that can help visualization during the bladder neck dissection
- List 2 visual cues that describe the retrotrigonal fascia
Outline and steps of the bladder neck dissection. (Click forward options):
- 08:05. Incise fat lateral to the DVC.
- 08:43. Incise the detrusor apron in the midline.
- 09:42. Incise the anterior prostatovesical junction.
- 10:39. Open the anterior urethra.
- 10:40. Drop the anterior bladder lateral to the urethra.
- 13:17. Incise the posterior urethra.
- 13:24. Incise the posterior prostatovesical junction.
- 13:34 + 14:24. Incise the retrotrigonal fascia.
- 14:00 + 15:53 + 16:18. Perform hemostasis to the lateral vascular bladder attachments.
Ethical approval:
This project was approved by the University of Ottawa Research Ethics Board.
This project received fundings from:
AO Foundation in the context of the AOEI Fellowship in Medical Education research.