The use of a bulldog clamp to control the dorsal vein complex during robot-assisted radical prostatectomy.
Optimal control of the dorsal venous complex (DVC) is a critical step in robot-assisted radical prostatectomy (RARP). If DVC is not controlled properly, bleeding may occur during the apical dissection. On the other hand, if it is controlled well, a bloodless field is attained and, thus, a precise apical dissection and urethral division is possible. Suture ligation is the most common technique used for dorsal vein control, while some authors recommend using an endovascular stapler. Recently, athermal division and selective suture ligation technique has been reported for DVC control. We describe a new technique: Use of a bulldog clamp to control the DVC during RARP. The control of the DVC with a bulldog clamp allows a bloodless field with precise apical dissection and provides preservation of maximum urethral length while avoiding sphincteral injury.
Department of Urology, Istanbul Acibadem University, Istanbul, Turkey. iltertuf@gmail.com
Ilter
I
Tüfek
Fatih
F
Atuğ
Burak
B
Argun
Selçuk
S
Keskin
Can
C
Obek
Enis
E
Coşkuner
Ali Riza
AR
Kural
D016063:Blood Loss, Surgical / Q000517:prevention & control; D006801:Humans; D008297:Male; D011467:Prostate / Q000098:blood supply* / Q000601:surgery*; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods*; D012371:Robotics; D013525:Surgical Instruments; D013536:Suture Techniques