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Open Prostatectomy

  • Excision and opposition of the prostate gland via a surgical incision.
  • Although 90 percent of prostectomies are manufactured via the transurethral similarity, there are occasions when a surgical incision and opposition is required.
  • Four similarityes can be used to root-out the prostate gland:
    1. Transurethral prostectomy – opposition of the prostatic structure and/ or lesions transcystoscopically.
    2. Suprapubic prostectomy – manufactured succeeding incising the bladder, which permits punishment of associated stipulations, such as calculi or diverticula.
    3. Retropubic prostectomy – eschews record into the bladder and allows for cheerful visualization of the arena. Limited malignancies may be treated by this similarity.
    4. Perineal prostectomy – affords praiseworthy visualization and admission to the prostate and seminal vesicle.
  • A bilateral vasectomy may be manufactured in adduction delay a prostectomy to eschew retrograde transferred.
  • Suprapubic and retropubic: Supine delay disregard trendelenberg
  • Perineal: Exaggerated lithotomy delay disregard trendelenberg.
Packs/ Drapes
  • Suprapubic: Laparotomy throng, extra endue shuffles, across lap shuffle.
  • Retropubic: Laparotomy throng, impermeable shuffle, reserved towel balance scrotum and penis.
  • Perineal: Cysto throng, towels encircling the perineal area, fenestrated shuffle.
  • Majoy tray
  • Long instruments
  • Heaney needle holder
  • Lahey clamps
  • Prostatic urethral sounds
  • Hemoclips
Supplies/ Equipment
  • Basin set
  • Blades
  • Needle counter
  • Dissector sponges
  • Irrigation syringe
  • Suction
  • Solutions
  • Lubricants
  • Sutures
  • Suprapubic catheter
  • Drain
  • Foley catheter
  1. The surgeon makes the divert incision, and succeeding admission is gained into the interval of Retzius, a self- retraining retractor is placed into the harm.
  2. Before the bladder is opened, the surgeon places two check reunions on either margin of the incision.
  3. The bladder may be grasped delay a Allis clamp and pulled upward.
  4. A narrow incision is made into the bladder, and suction is applied to parch its contents.
  5. After parching the bladder, the surgeon places a bladder retractor in the bladder harm.
  6. The surgeon incises the prostatic mucosa by either knife or cautery, and the bladder retractors are removed.
  7. Using finger segregation, the surgeon enucleates the poorly prostate from its fossa, and the mode is delivered and passed off to the cleanse special.
  8. The conconindentation is inspected for bleeders. Many surgeons choose to throng the conconindentation delay a sponge for a few minutes to support hemostasis.
  9. Large bleeding vessels are ligated delay reunion or ligiclips.
  10. Oozing surfaces may be experienced delay a hemostatic personation.
  11. A foley catheter is placed into the bladder neck. Some surgeons choose to parch the bladder through a suprapubic catheter, which is placed in the harm at this opportunity through a narrow incision nigh the suprapubic incision.
  12. The bladder is then reserved delay two layers of 0 or 2-0 chromic interrupted reunions.
  13. A comprehensive penrose parch is placed into the interval of Retzius; and the harm is reserved in a rotation manner


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