Anterior and Posterior Bladder Neck Dissection with Tension Stitch

Shiv Patel, M. Manganiello, D. Canes
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Abstract

Abstract Introduction: In this video, we demonstrate both the anterior and the posterior bladder neck dissection with tension stitch. Placing a suture in the posterior bladder neck is a common approach in patients with median lobes, whereby the median lobe is retracted with a figure-of-eight suture. Materials and Methods: The 30-degree down lens is utilized for the most optimal view of this dissection. Results: Multiple visual cues are utilized to determine the location of the bladder neck, including the limits of the anterior prostatic fat pad, excursions of the Foley balloon, and tissue response to pinching maneuvers. The initial dissection focuses primarily in the midline, aiming to get down to vertical fibers, which appear just before the catheter is exposed. If the lateral contours of the prostate are readily apparent, this tissue may be taken down as well, bearing in mind that bleeding is often encountered laterally as shown. Once the catheter is exposed, some lateral progression will help define th...
张力针前后膀胱颈清扫术
摘要简介:在这段视频中,我们展示了用张力针进行膀胱颈前路和后路解剖。对于有正中叶的患者,在膀胱后颈处放置缝线是一种常用的方法,即用8字形缝线将正中叶收回。材料和方法:利用30度下晶状体对解剖进行最佳观察。结果:利用多种视觉线索来确定膀胱颈的位置,包括前列腺前脂肪垫的界限,Foley球囊的偏移,以及组织对挤压操作的反应。最初的解剖主要集中在中线,目的是深入到导管暴露前出现的垂直纤维。如果前列腺的侧面轮廓很明显,也可以取下这个组织,记住出血经常发生在侧面,如图所示。一旦导管暴露,一些横向进展将有助于确定…
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