Step 4. Development of the space of retzius, DVC control and division of urethra K. Guru

Retropubic space of Retzius

The anterior attachments of the bladder are divided by dividing the urachus and medial umbilical ligamentsas cranial as possible to maintain adequate soft tissue surgical margins.
The space of Retzius is entered and the bladder is dropped. The dorsal venous complex (DVC) is exposed. The insufflation pressure is increased to 20 mmHg. The DVC can either be incised using the hook cautery (especially with a non-nerve-sparing procedure), or cold scissors (if nerve-sparing procedure is planned).
The DVC is oversewn using a barbed suture and pneumoperitoneum pressure is returned to 15 mmHg. The urethra is exposed and a large clip is applied across the urethra to prevent tumor spillage.
The urethra is divided and the specimen is placed in an Endo Catch bag (Covidien, Mansfield, MA, USA).