Laser prostatectomy images (DATA)

Abstract

File: prostatectomy1.jpg : The image shows the ventral side of the prostate during surgery. The prostate is approached through a caudal midline celiotomy. The bladder is retracted cranially and periprostatic fat is dissected to expose the prostate, as described in Chapter 4. File: prostatectomy2.png : We performed subcapsular partial prostatectomy, sparing the urethra and the dorsal aspect of the prostatic capsule including the neurovascular structures essential to the normal function of the urethral sphincter. A urethral catheter was inserted to allow localization of the urethra during surgery. A Nd:YAG surgical laser with a 600 μm optical fiber was used at 10 W (continuous wave) to incise the ventral part of the prostatic capsule along the midline. Prostatic tissue was bluntly separated from the capsule, then parenchymal segments were removed using laser dissection to control hemorrhage (see also the laser prostatectomy video). File: prostatectomy3.jpg : The urethra remained intact and prostatic tissue was removed on each side of the urethra as far dorsally as possible. File: prostatectomy4.jpg : Finally the edges of the capsule were trimmed and the capsule was sutured ventrally over the urethra without leaving dead space, using a continuous pattern. File: prostatectomy.mpg : The video shows Nd:YAG laser prostatectomy. The laser fiber is used in contact mode to dissect a prostate parenchyma segment during partial subcapsular prostatectomy of a dog. Laser dissection clearly induces proper hemostasis during cutting of prostate tissue.