Control of the Dorsal Vascular Complex

At the apex, the incision of the dorsal vascular complex should be tangential in order to avoid a positive surgical margin anteriorly. In cases with high suspicion of anterior tumor, the dorsal vascular complex is directly transected as distal as possible, leaving a sufficient amount of vascular structures on the anterior aspect of the prostatic apex and without placing a hemostatic suture prior to incision.

It is always possible to control the bleeding from the dorsal vascular complex, and raising the pressure of the pneumoperitoneum up to 20 mmHg during the stitching is definitively helpful.

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