retropubic radical prostatectomy

The incidence of prostate cancer is second only to lung cancer in countries such as Europe and the United States. It is also an increasing trend in China. Patients with a retropubic prostatectomy for prostate cancer a(i) and b(ii) can achieve good results. Prostatectomy with perineal prostate has good results and fewer complications. Radical prostatectomy requires a needle biopsy through the rectum and perineum before surgery, and b-mode ultrasound or ct examination can be performed. Treatment of diseases: prostate cancer Indication Patients with prostate cancer. Surgical procedure 1. Incision: median lower abdomen longitudinal incision, patient position, incision length and prostate exposure are all associated with retropubic prostatectomy. 2. Catheterization: The bladder is evacuated with a catheter and the tube is left in place. 3. Cutting the pubic urethral ligament: The pubic urethral ligament is separated, and the ligament is severed by the indication. 4. Separate the prostate: From the tip of the prostate, separate the back of the prostate with your fingers and separate the attachment to the adjacent tissue. 5. Cut off part of the urethra: Partially cut the urethra until the catheter in the urethra is seen. 6. The anterior edge of the urethra is sutured: the upper edge of the incision of the urethral incision is sutured with a chromic gut line of 0, which helps the anastomosis of the bladder neck and the urethra. 7. Cut the urethra: cut the urethra around the circumference, place the starch sponge on the prostate bed, hook the gauze with a small deaver retractor, and control the bleeding of the pelvic venous plexus and other blood vessels. 8. Separate the seminal vesicles: separate the seminal vesicles separately, and ligature and cut off the vas deferens. 9. Probe transfer: At this time, carefully stop bleeding and explore the presence or absence of lymph node metastasis. 10. Hemostasis: After removing the pubic bone, the gauze is blocked, and the bleeding point of clamping, ligation or electrocoagulation is obvious. 11. Open the bladder: Cut the anterior wall of the bladder close to the upper edge of the prostate, cut the bladder neck, remove the prostate, and insert the ureteral catheter into the ureter via the ureteral orifice. 12. Connect the urethra and the bladder: sew the 0-gauge gut in the urethra and sew it to the bladder neck. A total of 4 needles were sutured intermittently to join the urethra and bladder outlet, but not ligated. 13. Indwelling balloon catheter: a balloon catheter is placed through the urethra, the bladder cavity is introduced, the balloon is inflated, the catheter is pulled, the bladder is pulled toward the urethra, and the indwelling suture is ligated and the anterior wall of the bladder is sutured. 14. Stop bleeding again: Put starch foam on the front and sides of the anastomosis to ensure hemostasis. 15. Stitching: Cigarette drainage was performed in the area around the bladder, and the incision was sutured layer by layer.

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