Anterior retraction of the prostate during robotic-assisted laparoscopic radical prostatectomy using the closure device.

Of those surgeons using laparoscopic radical prostatectomy (LRP) for localized prostate cancer, with or without robotic-assistance (RALRP), most prefer the antegrade approach to dissect the prostate and neurovascular bundles. After dividing the anterior bladder neck, a key manoeuvre is adequate anterior retraction of the prostate to allow safe and timely dissection of the posterior bladder neck. During LRP, this step is commonly achieved by inserting a curved metal sound through the urethra, allowing the assistant to maintain upward traction on the prostate while dissection of the posterior bladder neck proceeds. However, this manoeuvre is rendered all but impossible during RALRP as the camera arm of the da Vinci® (Intuitive ET AL.