Introduction: Retzius sparing prostatectomy has grown in utilization since its publication in 2010 by Galfano et al. Preliminary reports suggest earlier return of urinary continence with equivalent erectile function. The surgery learning curve is steep and has been reported to require 30-40 operations to obtain mild proficiency. We attempted to identify easy modifications and tips to flatten the learning curve.
Methods: We illustrate surgical tips to include delayed seminal vesicle dissection, improved peritoneum incision, ureteral identification and bladder neck tagging. We found that delayed seminal vesicle dissection is an easy reproducible tool to allow for posterior dissection with no need for additional support sutures.
Results: This video safely shows posterior dissection of the seminal vesicles and vas deferens and improved bladder neck marking techniques.
Conclusions: Our modifications have provided safe alternatives to continue to improve outcomes with retzius sparing prostatectomy.
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