Figure 2

Simultaneous perineal and abdominal surgery under a lithotomy position. A. After mobilizing the peritoneum from the Retzius space to the iliac bifurcation on the abdominal side, the perineal team dissects between the layers of Denonvilliers’ fascia behind the prostate and seminal vesicles. B. Division of the bilateral pedicles is performed with the aid of both the perineal and abdominal teams. C. The puboprostatic ligaments and dorsal vein complex are safely divided using a sealing surgical device through a perineal approach.