What are the initial steps in radical cystectomy?

Updated: Nov 27, 2016
  • Author: Michael Christopher Large, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Make a vertical midline incision from symphysis pubis to a few centimeters above or below the umbilicus, depending upon a patient's habitus. Enter the peritoneum above the umbilicus and incorporate the urachal remnant into the specimen. Palpate the pelvic and abdominal viscera and collect frozen section biopsy samples of any suspicious sites. Expose the ventral bladder and prostate. Identify, ligate, and divide the vas deferentia or round ligaments. Continue the peritoneal incision laterally to expose the aortic bifurcation, common iliac arteries, and external iliac arteries.

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