Ergonomic use of the fourth arm to oversew the dorsal vascular complex (DVC) during robot-assisted laparoscopic prostatectomy (RALP).

Karim, Omer; Rao, Amrith; Marsdin, Emma; Kavia, Rajesh; Parnham, Arie; Motiwala, Hanif; Laniado, Marc · BJU Int · 2013

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Abstract

To demonstrate an ergonomic fourth arm technique to oversew the dorsal vascular complex (DVC) during robot-assisted laparoscopic prostatectomy (RALP). 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. Oversew of DVC with minimal patient-side surgical assistance. About a 50% reduction in apical positive margin rate. A useful, ergonomic method of oversewing the DVC during RALP.

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