During the procedure, whilst under general anaesthetic 5 small holes are used to introduce instruments into the pelvis. These instruments are used incise the endo-pelvic fascia and suture ligate the dorsal venous complex. The bladder is then cut away from the prostate. Dissection forward under the prostate leads to the vasa, which are cut, and seminal vesicles that are removed in entirety unless the procedure is nerve sparing. Attention is then turned to the apex of the prostate and mobilisation seeks to preserve as much urethral length as possible.When free the prostate is placed in a small bag and removed through one of the port sites, which is enlarged to the size of the prostate. Some of the pelvic lymph glands, especially those from the obturator fossa may be removed in selected cases.
The bladder is then sutured to the urethra, leaving a catheter in the penis.