Objective: To demonstrate an ergonomic fourth arm technique to oversew the dorsal vascular complex (DVC) during robot-assisted laparoscopic prostatectomy (RALP).
Patients and 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.
Conclusion: A useful, ergonomic method of oversewing the DVC during RALP.
© 2012 The Authors BJU International © 2012 BJU International.