The single needle method for urethrovesical anastomosis with strengthened posterior fixation during laparoscopic radical prostatectomy

Abstract

The single needle method for urethrovesical anastomosis with strengthened posterior fixation during laparoscopic radical prostatectomy was explored. The method was initiated by performing a fixing suture with a knot at 4 o'clock of the posterior lip of bladder neck, and another suture at nearby position was performed to leave the knot outside. From 5 o'clock to 8 o'clock, sutures were performed every one o'clock to secure posterior approximation, then every two o'clock a suture. To avoid a loose anastomosis, lock sutures were performed every 3 sutures. The needle was always driven full-thickness outside-in in the bladder neck and inside-out on the urethra. After completing the full circumference, the needle was drawn near the 4 o'clock and tied at the tail end. Any leakage could be closed with additional interrupted sutures. The clinical data of 89 patients who underwent this method were retrospectively compared with those of 23 patients who underwent the single knot method. The results showed that the anastomosis, operative and catheterization time was 17.6+/-4.7 min, 134.0+/-10.7 min and 6.5+1.6 days respectively. There were 3 temporal urinary leakages identified in 89 cases requiring prolonged catheterization. No urinary leak and anastomotic stricture was confirmed, and 95.2% patients had total urinary control. It was concluded that this method was simple and safe for urethrovesical anastomosis.

Laparoendoscopic Single-Site Urethrovesical Anastomosis Training in an Economical Porcine Model

“…A 12-F Foley catheter was placed through the urethra by an assistant to identify the urethral lumen. UVA was performed with a running suture, as previously described [7]. Once all suture procedures were completed, the anastomotic stoma was cut off and checked extracorporeally.…”

Oncological and functional results of extraperitoneal laparoscopic radical prostatectomy

“…Upon increasing experience, temporary urinary leakage seldom occurred. The details of SNM and initial results compared with the results of several other methods of urethrovesical anastomosis that have been published (4). A short median time for anastomosis, a short median placement time of the retropubic drain, no postoperative persistent urinary leakage and no anastomotic stricture indicated that SNM was a simple and efficient method.…”

“…Between March 2005 and March 2010, we performed 329 cases of extraperitoneal laparoscopic radical prostatectomy (ELRP) with running urethrovesical anastomosis using the single needle method (4). In this study, we evaluated the oncological and clinical results after ELRP.…”

A matched-pair comparison between bilateral intrafascial and interfascial nerve-sparing techniques in extraperitoneal laparoscopic radical prostatectomy

“…A running urethrovesical anastomosis using a 25-cm, 2-zero Monocryl suture with a UR-6 tape needle (Ethicon Inc.) was Bilateral intrafascial and interfascial nerve-sparing techniques T Zheng et al 514 performed. 12 To test the integrity of the urinary reconstruction, the bladder was filled with 200 ml saline. Any saline extravasation identified during this manoeuvre could be controlled with additional interrupted stitches.…”