Millin Prostatic Lobe Holding Forceps — Enucleation Grasp

Millin Prostatic Lobe Holding Forceps — Enucleation Grasp

The Millin prostatic lobe holding forceps engages each prostatic lobe during the retropubic enucleation step of Millin’s prostatectomy — the technical highlight of the operation where the adenoma is digitally or instrumentally separated from the surgical capsule and delivered through the prostatic capsulotomy. The forceps’s specific jaw geometry grips the dense adenomatous tissue without slipping while the operator’s other hand performs the enucleation.

The enucleation technique

After Millin’s anterior capsulotomy and dorsal-vein-complex ligation, the operator identifies the plane between the adenoma and the surgical capsule (an avascular plane in benign prostatic hyperplasia) and develops it digitally. The Millin lobe forceps grasps each lobe (left, right, middle) in turn for traction during the dissection. The lobes are then delivered through the capsulotomy and the bladder neck reconstructed to prevent post-operative incontinence.

The modern context

Open Millin prostatectomy persists for very large adenomas (>80-100g) where transurethral and laser-enucleation techniques become impractical. The Millin lobe forceps remains the gold-standard instrument for this select indication.