□ Fig. 9.1. 3D diagram of anatomical landmarks for TURP. Endoscopic views of lateral lobe adenoma at the bladder neck (right top) and lateral lobe adenoma at the level of the verumontanum (right bottom)

□ Fig. 9.2. Step 1: Trench resection from the bladder neck to the verumontanum starting at 6 o'clock position
Verumontanum Anatomy
□ Fig. 9.4. Step 3: Resection of the right lobe

□ Fig. 9.6. Step 5: Apical resection. Resection of the left apical tissue, with the verumontanum at 6 o'clock position (right top). Complete clearance of apical tissue, viewed from the urethral sphincter (right bottom)

Prostate Internal Sphincter

□ Fig. 9.7. Step 6: Resection of residual tissue at posterior bladder neck. Right bottom: Resection of obstructing circular fibres of the internal sphincter at the bladder neck

Internal Catheter Bladder

□ Fig. 9.8. Cystograms following TURP. Normally, catheter balloon positioned at bladder outlet occluding the prostatic cavity (left). Catheter balloon positioned within the prostatic cavity in cases where tamponade is required (middle). Insufficient tamponade from catheter balloon in prostatic cavity (right)

Rectoscope Sheath

□ Fig. 9.9. Fixation of the sheath of the resectoscope with the nondominant hand at the symphysis pubis region, so that the tip of the sheath lies at the level of the verumontanum: Resection from 5-7 o'clock (left), resection of the left lateral lobe (middle), resection of the ventral part of the adenoma from 10-2 o'clock (right).

Minimal Invasive Transurethral Resection of the Prostate

Jan Fichtner

Introduction - 90 Anaesthesia - 90 Indications - 90 Contraindications - 90 Instruments - 90

Operative Technique (Step by Step) - 90 Operative Tricks - 90 Postoperative Care - 90 Image Gallery - 91

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