title: Ergonomic use of the fourth arm to oversew the dorsal vascular complex (DVC) during robot-assisted laparoscopic prostatectomy (RALP).
abstract: OBJECTIVE
  To demonstrate an ergonomic fourth arm technique to oversew the dorsal vascular complex (DVC) during robot-assisted laparoscopic prostatectomy (RALP).
  
  
  METHODS
  Balloon of a Foley catheter inflated in the bulbar urethra. Fourth arm cranial traction via suture in the tip of the catheter. DVC oversewn under direct vision.
  
  
  RESULTS
  Oversew of DVC with minimal patient-side surgical assistance. About a 50% reduction in apical positive margin rate.
  
  
  CONCLUSIONS
  A useful, ergonomic method of oversewing the DVC during RALP.
authors: Centre for Robotics and Minimally Invasive Surgery, Wexham Park Hospital, Slough, Berkshire, UK. omer.karim@mac.com
authors: Omer
authors: O
authors: Karim
authors: Amrith
authors: A
authors: Rao
authors: Emma
authors: E
authors: Marsdin
authors: Rajesh
authors: R
authors: Kavia
authors: Arie
authors: A
authors: Parnham
authors: Hanif
authors: H
authors: Motiwala
authors: Marc
authors: M
authors: Laniado
mesh_terms: D004868:Equipment Failure; D006804:Ergonomics; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods*; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D013536:Suture Techniques; D013537:Sutures; D014546:Urinary Catheterization