The application of a blunt‐tip needle to suture the dorsal venous complex in robot‐assisted laparoscopic radical prostatectomy

Zhang, Chao; Wang, Huiqing; Wang, Hongzhi; Guo, Fei; Yang, Bo; Xu, Chuanliang; Sun, Yinghao

doi:10.1002/rcs.1822

Cited by 3 publications

(3 citation statements)

References 16 publications

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“… 14 – 16 A groove between the prostatic apex and the membranous urethra was identified during laparoscopic RP, which was the lateral aspect of the avascular area. 25 Sewing the DVC with a blunt needle from this groove could better control the DVC and the authors named this anatomical landmark the ‘golden eye’. 25 In addition, some researchers have changed the shape of the DVC to make it easier to suture.…”

Section: Evidence Summarymentioning

confidence: 99%

“… 25 Sewing the DVC with a blunt needle from this groove could better control the DVC and the authors named this anatomical landmark the ‘golden eye’. 25 In addition, some researchers have changed the shape of the DVC to make it easier to suture. 26 , 27 The DVC was narrowed and compacted by extrusion through the traction of the urethral probe or the temporary clamping of the laparoscopic intestinal clamp, which permitted easier suturing.…”

Section: Evidence Summarymentioning

confidence: 99%

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The progress of dorsal vascular complex control strategy in radical prostatectomy

et al. 2023

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Radical prostatectomy has undergone a development from open to laparoscopic surgery to a surgical robotic approach. With improved surgical equipment and the continuous development of surgical techniques, various surgical strategies for controlling the dorsal vascular complex (DVC) during RP have been investigated, which affect intraoperative blood loss, postoperative tumour control and postoperative urinary and sexual function. The present narrative review summarizes the latest anatomical information about the prostatic apex and DVC and then describes the three types of DVC control. More detailed anatomy of the DVC is required and the optimal DVC control under different situations needs further research.

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Section: Evidence Summarymentioning

confidence: 99%

Section: Evidence Summarymentioning

confidence: 99%

The progress of dorsal vascular complex control strategy in radical prostatectomy

et al. 2023

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“…D-DVC technique is also widely used in the laparoscopic surgery under pneumoperitoneum [ 3 ]. However both techniques are difficult steps for novice surgeons because the S-DVC needs precise needle passage in suturing the DVC and the depth of the stitch for ligation is not always clear [ 4 ]. On the other hand, it is necessary to suture precisely and rapidly the DVC under some bleeding in the D-DVC technique.…”

Section: Introductionmentioning

confidence: 99%

Division of dorsal vascular complex using soft coagulation without suture ligation during robot-assisted laparoscopic radical prostatectomy: a propensity score-matched study in a single-center experience

Kuroki

Harimoto

Kimura

et al. 2022

Cent european J Urol

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Introduction Apical dissection and control of the dorsal vascular complex (DVC) affects blood loss, positive surgical margins, and urinary control during robot-assisted laparoscopic radical prostatectomy. Soft coagulation is widely used for hemostasis. However, using soft coagulation to the DVC may affect the continence outcomes. In this study, we described technique and outcomes for division of the DVC after soft coagulation (DVC-SC) compared with delayed ligation of the DVC (D-DVC). Material and methods Medical records of 170 patients who underwent robot-assisted laparoscopic radical prostatectomy from June 2016 to March 2020 were retrospectively reviewed. To reduce the selection bias, the two groups were matched in a 1:1 ratio on the basis of propensity scores. Perioperative data and results were compared in both groups. Results Patients undergoing DVC-SC experienced less estimated blood loss compared to patients undergoing D-DVC (median: 105.5 vs 225 ml, p = 0.017). Postoperative continence rates at 1 week, 1, 3, 6 months in DVC-SC group and D-DVC group were 32.5% versus 15%, 62.5% versus 32.5%, 85% versus 67.5%, 95% versus 90%, respectively. Continence was significantly better at 1 month with DVC-SC versus D-DVC (p = 0.013). Conclusions Division of the DVC after soft coagulation technique did not affect continence after robot-assisted laparoscopic radical prostatectomy despite the thermal division and gave the surgeon good hemostasis with simple procedure.

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Use of a linear stapler for urethral and dorsal vein complex transection during laparoscopic total pelvic exenteration in rectal cancer

et al. 2019

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The application of a blunt‐tip needle to suture the dorsal venous complex in robot‐assisted laparoscopic radical prostatectomy

Abstract: Using a blunt-tip needle to suture the DVC may reduce DVC-related bleeding and provide a better surgical field. It may be helpful in improving postoperative continence. However, its effect on positive margin at the apex still needs further investigation.

Cited by 3 publications

References 16 publications

The progress of dorsal vascular complex control strategy in radical prostatectomy

The progress of dorsal vascular complex control strategy in radical prostatectomy

Division of dorsal vascular complex using soft coagulation without suture ligation during robot-assisted laparoscopic radical prostatectomy: a propensity score-matched study in a single-center experience

Use of a linear stapler for urethral and dorsal vein complex transection during laparoscopic total pelvic exenteration in rectal cancer

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