Step 2. Establishing the plane at verumontanum P. Gilling

Bilateral bladder neck incisions are then made, extending from the ureteric orifices to the verumontanum. These are deepened down to the level of the surgical capsule, which can be clearly identified as a smooth fibrous layer. It is important to create incisions with cleanly defined edges to aid in their identification, particularly when the lobes are large. If no median lobe is present, a single incision can be made at the 6 o’clock position. Throughout the procedure, haemostasis is obtained using the defocused laser as each of the bleeding vessels is encountered.

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