Patient Preparation

The patient is put in deflected supine position with the arms at the sides and the legs adducted. Additionally, a 30-degree Trendelenburg decline supported with inflatable balloon pillow was placed under the patient's buttocks, which displaces the bowel cephalad by gravity. The abdomen is shaved from the costal margins to the pubic bone. A rectal balloon catheter is placed and inflated with 70 cm3. Before trocar placement, a 16-French Foley catheter is inserted under sterile conditions and blocked with 15 cm3 saline. The procedure can be divided into several important steps.

TABLE2 ■ Armamenterium of Laparoscopic Radical Prostatectomy in Heilbronn Experience

Name

No.

Notes

Manufacturer

Manufacturer number

Equipment:

Light source

1

Xenon light source 615, power ~70%

Storz

Digital camera system

1

IMAGE1™

Storz

22200020

High-flow insufflator,

1

Flow 20 L/min

Storz

Thermoflator

Laparomat

26432020

Video monitor

1

Sony

Storz

HF generator Erbotom

1

Monopolar max 90 W, bipolar max 50 W

Erbe

ICC 350

Diathermy

(separate foot pedals

for monopolar and bipolar)

Martin retractor (holder):

1

Fixing retracting forceps

Martin

Arm

1591001

Screw

1591051

Aesop "3000,"voice-

1

Computer Motion

controlled robot

Air gun

1

Used to inflate the dorsal balloon

Storz

27660

General set:

Dorsal balloon

1

2 sizes are needed

Rusch

815000

Light cable

1

Storz

495 NCS

Optic (telescope)

1

10 mm, 30°

Storz

26003 BA

Gas tube:

1

Filter

1

MTP (Storz)

031122-01

Luer lock adaptor

1

Storz

600007

Monopolar cable

1

Used with scissors

Storz

26002 ML

Bipolar cable

1

Used with special endodissector

Aesculap

GN 073

Suction-irrigation device

1

5 mm

Storz

26173 BN

Ring head organ grasper

2

"Krause"for mechanical morcelation

Aesculap

SB 51386

Sharp towel holder

2

"Tuch-kleme"

Aesculap

BF 433

Ruler (20 cm)

1

"Sargel" for measuring sutures length

Sulzer

95.00.03

Veress needle 2.1-mm

1

Wolf

8302.12

12.5-mm metal trocar

1

For camera and retrieval

Storz

HZ 30107

Sharp introducer for

1

Storz

30107 P

12.5-mm trocar

Valve for 12.5 mm trocar

1

Storz

30107 M1

with rubber cap 60/13

Sheath reducer with rubber

1

12 mm

Storz

30140 HE

cap 60/10 for 12.5-mm trocar

10-mm metal trocar

2

Storz

30103 HZ

Sharp introducer for

2

Storz

30103 P

10-mm trocar

Valve for 10-mm trocar with

2

Storz

30103 M1

rubber cap 60/10

Sheath reducer with rubber

2

Storz

30140 DB

cap 50/4 or 10-mm trocar

5-mm metal trocar

3

Storz

30160 M

Sharp introducer for 5-mm trocar

3

Storz

30160 P

Valve for 5-mm trocar with

3

Storz

30160 M1

rubber cap 50/4

Sheath reducer with rubber

1

Mainly for pediatric use

Storz

30140 KA

cap 50/2.6 for 5-mm trocar

Double cup reducer: 13/10,

1

Storz

30142 HB

13/5 for 12.5-mm trocar

Cup reducer: 10/5 for

2

Storz

30141 HB

10-mm trocar

Rubber cups: 60/13,

3

Storz

50/4, 60/10

Endoscissors:

2

5 mm

Storz

Inner part

34310 MS

Shaft

33300

Handle

(Continued)

TABLE 2 ■ Continued

Name

No.

Notes

Manufacturer

Manufacturer number

5-mm endo-right angle:

1

Storz

Inner part

33310R

Shaft

33300

Handle

33121

10-mm endo-right angle:

1

Storz

Inner part

30420 RG

Shaft

33500 PV

Handle

33131

5-mm endo-dissector:

2

Storz

Inner part

33310MD

Shaft

33300

Handle

33121

5-mm self-retained

2

Storz

endograsper:

Inner part

33310 G

Shaft

33300

Handle

33123

5-mm atraumatic clamp:

1

Used to hold the kidney or

Storz

Inner part

intestine

33310C

Shaft

30512

Handle

30525 S

10-mm 120° endodissect

1

Aesculap

"Abbou":

Inner part

PO 661 R

Shaft

PM 975 R

Handle

PO 950 R

10-mm 120° endodissect

1

Storz

"Rassweiler":

Inner part

33510 MLL

Shaft

33500 PV

Handle

33131

Endo peanut sponge holder

1

Storz

(grasper self-retained):

Inner part

33310 PT

Shaft

32121 K

Handle

32121 H

Bipolar dissector

1

The hole instrument

Aesculap

PM 401 R

(310-mm long):

Inner part

PM 431 R

Shaft

PM 973 R

Handle

PM 450 R

10-mm endo-single stapler

1

Medium size, charge single staple

Ethicon

LC 3010 R

each time

5-mm endo-needle

1

For puncturing cysts

Storz

26175 P

10-mm endo stapler

1

With magazines of 8 medium to large

Aesculap

PL 536 R

Challenger-Ti

size clips

Carter-Thomasson fascial

1

Reusable instrument for fascia closure

closure device

Instrument brush

1

For cleaning

Exclusive for laparoscopic radical prostatectomy:

Needle holder 5-mm

1

Non-self-retaining scissors-like

Dufner

26918-01

handles

Needle holder 5-mm

1

Self-retaining palm handle

Storz

26173 SK

5-mm self-retained

1

Used to hold the catheter

Storz

endograsper:

Inner part

33310 G

Shaft

33300

Handle

33123

The approach to the apex of the prostate is determined by the decision of proceeding with nerve-sparing or nonnerve-sparing technique.

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