Cutting Edge Urology

T his PDF belongs to matthew.hooson@springer.co 10 • CUTTING EDGE - UROLOGY Step 3: Adenoma Dissection (Table 3) The urethral catheter is pulled back into the urethra after deflating the balloon, and a stay suture is used to elevate the median lobe using the fourth robotic arm. With the median lobe retracted anteriorly, a mucosal incision is made at the junction between the median lobe and the trigone using hot monopolar sc ssors. This incision is deepened to reach the plane of the adenoma at the junction between the adenoma and the compressed peripheral zone and capsule of the prostate (Fig. 10). Table 3: Instrume ntation required for step 3: adenoma dissection. Surgeon instrumentation Assistant instrumentation Left arm Right arm Fourth arm • Laparoscopic suction irrigator • ProGrasp™ forceps • Monopolar scissors • ProGrasp™ forceps • Tenaculum forceps • Endoscope lens : 0° Fig. 9: Insertion of bilateral ureteral stents. ( a ) A 2-mm mini-port is inserted into the suprapubic area. ( b ) Guide wire insertion and left ureteral stent placement. ( c ) Right ureteral stent placement. ( d ) Final aspect showing bilateral ureteral stents. Cutting EDGE_Urology(SUN)_final.indd 10 27-Mar-18 10:00:27 AM