Step 4. Specimen removal and vaginal reconstruction K. Guru

After development of the retropubic space similar to male RARC, the urethra is exposed by applying traction to the whole specimen. Manipulation of the Foley catheter helps to identify the urethral meatus. The urethra is removed en bloc, the specimen is placed in an Endo Catch and retrieved transvaginally. The vagina is closed transversely toprevent the creation of a narrow dysfunctionalvagina.

Preservation of anterior vaginal wall is based on oncological planning prior to RARC. Development of the anterior vaginal space is recommended to preserve adequate length of anterior vaginalwall.