Comparison of two different suture techniques in laparoscopic partial nephrectomy

Abstract

Objective:To comparatively evaluate the traditional interrupted knot-tying and running suture renorrhaphy with Monocryl® in laparoscopic partial nephrectomy (LPN).Materials and Methods:A retrospective analysis of 62 consecutive patients undergoing LPN using traditional interrupted knot-tying suture renorrhaphy (Group 1; n=31) or running suture technique renorrhaphy with 2-0 monofilament polyglecaprone (Monocryl®, Ethicon) (Group 2; n=31) from December 2011 to October 2015 at the University. All patients underwent LPN performed by an experienced laparoscopic surgeon. The demographic, perioperative and postoperative parameters were compared between the groups, and the effect of both suture techniques on the warm ischemic time (WIT) and trifecta were evaluated.Results:The running suture renorrhaphy with Monocryl® reduced WIT, estimated blood lost and length of hospitalization stay significantly without increasing postoperative complication rate during LPN in comparison with interrupted knot-tying suture.Conclusion:The renorrhaphy using the running suture with Monocryl® is an effective and safe technique with the advantage of shortening WIT even in more challenging and larger tumors during LPN.

Suture techniques during laparoscopic and robot‐assisted partial nephrectomy: a systematic review and quantitative synthesis of peri‐operative outcomes

“…Surgical bolsters were used to shallow defects in the early robotic experiences , but were rarely used in more recent series (Table ). To reduce renorrhaphy time, some authors reported the use of self‐retaining barbed sutures either for inner‐layer renorrhaphy or during cortical renorrhaphy . Minervini et al.…”

“…Among studies included in the quantitative analysis comparing running vs interrupted sutures, four studies reported a dedicated suture of the UCS (Table ). The most common suture used was 2/0 or 3/0 polyglactin sutures.…”

Comparative Study Between Polydioxanone Unidirectional Barbed Suture and Absorbable Polyglactin Running Suture in Partial Nephrectomy

“…Knowing that running suture reduce the warm ischemia time indifferent of tumor size and location [6], and laparoscopic knot tying is time consuming and often are weaker than those tied by hand in open surgery [7][8][9], we recommend for laparoscopic nephron sparing surgery by retroperitoneal approach (which provides little space for maneuver) a knotless running suture for rennorhaphy, with end-tails Hem-o-lock TM clips to secure the suture. Table 2 MEDIUM RISK ZONAL NePhRO SCORE (7)(8)(9) Both suture materials used for renorrhaphy present good outcomes in terms of biodegradability [7,10], the suture requiring a good tensile strength for over a month in order to maintain good hemostasis and facilitate renal healing.…”

Needle Adjustment Free (NAF) running suture technique (PAN suture) in laparoscopic partial nephrectomy

“…Therefore, various kinds of suture methods, materials, and instruments have emerged, such as the continuous interlocking technique, Lembert technique, Connell technique, Gambia technique and Zipper technique for running suture of the cavity organ wall [ 2 ]. Likewise, the single needle continuous suture method has been used in urethro-bladder neck anastomosis in radical prostatectomy [ 3 ] and the running suture technique in laparoscopic nephron sparing nephrectomy [ 1 , 4 ]. Several studies have also reported barbed sutures such as V-Loc™ and simplified sutures methods which benefited the surgery [ 5 – 8 ].…”