Step 4. Lateral and anterior disection F. Gomez Sancha

The dissection is aimed ventrally and the bladder is spontaneously entered at 11 o’clock just by following the anatomical plane between capsule and adenoma. Then, the bladder neck is incised toward 12 and 7 o`clock. Once the right side is released completely from the capsule, the same steps are carried out on the other side. When all lateral and anterior aspects of the adenoma are free, the cresta urethralis is cut at 6 o’clock and the posterior aspect is liberated. 

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Mechanical dissection of the plane between capsule and lateral lobe is performed, alternating with hemostasis (5–7). The bladder is entered anteriorly and cut toward 7 and 12 o’clock (8)

Figure procedure-steps