Transection of the Vesical and Prostatic Vascular Pedicle

At this point the bladder is pulled laterally and the rectum posteriorly to expose the lateral pedicle. The vascular control can be performed by either Endo-GIA staplers, harmonic scalpel, surgical clips, bipolar cautery, or a combination (Fig. 8). The unincised peritoneal lining includes the vas deferens, which is secured during the complete transection. If non-nerve-sparing surgery is employed, the transection can simply be taken down to the prostatic apex. If a nerve sparing dissection is planned, the nerves must be teased off the base of the prostate and seminal vesicles as in laparoscopic radical prostatectomy.

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