Comparison between a novel knotless technique and the conventional single knot technique of laparoscopic radical prostatectomy by novice laparoscopists

Abstract

ObjectivesThis study aimed to investigate a novel knotless technique for novice laparoscopists in traditional laparoscopic radical prostatectomy.MethodsWe studied 68 patients who had a novel technique performed in laparoscopic radical prostatectomy (knotless group) and 89 who had the conventional single knot technique (single knot group). The operations were all performed by novice laparoscopists with experience of fewer than 100 cases of laparoscopic radical prostatectomy. Knotless suture of the dorsal vein complex was conducted using a barbed self-retaining suture with three bites at the same location. The knotless urethrovesical anastomosis technique was conducted using a unidirectional single running fashion with a barbed self-retaining suture.ResultsThere were no significant differences in the estimated blood loss, complication rate, postoperative hospital stay, anastomotic leakage rate, continence at 6 months after surgery, and positive margin rate between the two groups. The mean anastomotic time (24.9 vs. 44.2 min), operative time (168.1 vs. 201.8 min), and duration of catheter placement (12.8 vs. 19.8 days) were shorter in the knotless group than in the single-knot group.ConclusionsThe knotless technique of laparoscopic radical prostatectomy is a safe and effective procedure.

The progress of dorsal vascular complex control strategy in radical prostatectomy

“… 21 , 22 These two studies found that this treatment was safe and rapid without increasing postoperative positive margins (PSM), urinary incontinence and biochemical recurrence. 21 , 22 In addition, researchers have treated the DVC with a plasma knife or unidirectional knotless barbed sutures (V-Loc®) instead of conventional polyglactin sutures to sew knotless DVC, 23 – 24 both of which provided safe and rapid control the DVC. Laparoscopy provides a good view of the surgical field, which helps the surgeon to locate the key anatomical landmarks for DVC suture.…”