Robotic Radical Prostatectomy - STEP 4- Dorsal Venous Complex (DVC) Suture Control

The following video will highlight the technique of robotic endopelvic fascial dissection and dorsal vein complex suture control. This is video 4 of 10 in a series focused on robotic radical prostatectomy for localized prostate cancer.

One of the greatest areas of blood loss during open radical prostatectomy is from the dorsal venous complex. The dorsal venous complex (DVC) is composed of a network of venous tributaries that drain the phalus and pelvic structures. They convalesce into one large venous plexus that sits right ontop of the prostate and just beneath the pubic bone. In open surgery, with the angle of the skin incision and the pubic bone arch, it is extemely difficult to accurately visualize and manuall sew up the venous plexus, especially if there is active bleeding. In robotic surgery, coupled with the pneumoperitoneal pressure of carbon-dioxide gase, and the optimal magnified vision and miniature wristed instruments, the blood loss is significantly reduced. On average, robotic surgery blood loss in our hands is less than 200mL with a risk of blood transfusion decreased to 0.6%.

Video by Dr. Kevin Zorn.