Anterior retraction of the prostate during robotic‐assisted laparoscopic radical prostatectomy using the closure device

Abstract

We have used this technique in over 700 cases of RALRP and have been pleased with its performance. The technique is quick and easy to adopt. It provides efficient anterior retraction of the prostate and frees the bedside surgeon or fourth arm of the robot to assist in other ways. We have noted no complications related to the use of this device in our experience to date. The Endo Close device is an inexpensive addition to the laparoscopic consumables cost of a RALRP and can also be used at the end of the case to assist in trocar site closure. Troubleshooting: It is important to introduce the Endo Close in the midline and close to the symphysis pubis to achieve the correct angle for catheter retraction. It can be difficult to choose the precise insertion point in the insufflated abdomen when the robotic cart is docked over the patient. Therefore we routinely mark an insertion point 1 cm above the symphysis pubis at the start of the case, before insufflating the abdomen. This point is easily identified even when the robot has been docked and allows insertion of the Endo Close at precisely the correct location. © 2009 The Authors.