Patient Positioning

Following general anesthesia and gastric decompression, an 18 French urethral catheter is placed in the bladder. We prefer to use a catheter with a 30 cc balloon to aid in intraoperative identification of the trigone and bladder neck. The patient is positioned supine on spreader bars with both arms tucked alongside the body. Spreader bars allow

An exaggerated Trendelenburg position may lead to excessive facial edema and paresthesias.

FIGURE3 ■ Depicted here are 10 mm (X) and 5 mm (x) port size locations for laparoscopic seminal vesicle excision.

The surgeon must carefully identify and stay away from the ureters. If there is any question as to their location or proximity to the seminal vesicles, an externalized ureteral stent can be placed via flexible cystoscopy to identify the ipsilateral ureter.

easy access to the rectum where an O'Conor drape is placed to allow digital prostatic mani-pulation during the procedure. The table is gently flexed to open up the pelvis and a moderate Trendelenburg position is used to allow gravity retraction of the bowels.

An exaggerated Trendelenburg position may lead to excessive facial edema and paresthesias.

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