A New Technique for Laparoscopic Vesicourethral Anastomosis: Preliminary Report

Emiliozzi, P.; Martini, M.; D’Elia, G.; Scarpone, Paolo; Pansadoro, A.; Pansadoro, Vito

doi:10.1016/j.urology.2008.07.003

Cited by 10 publications

(15 citation statements)

References 13 publications

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“…In this study, the overall continence rates in both groups under investigation were comparable with, or better than, the reported in other LRP series [9,10,12,14,21,22,23]. It has to be noted that in this study, we preserved the bladder neck using our own technique in all patients to avoid a potential bias that could have affected the analysis of continence outcomes [13,14].…”

Section: Discussionsupporting

confidence: 81%

“…In an attempt to simplify this critical step of LRP, several authors have proposed different techniques for the VUA [7,8,9,10,11,16]. The single-knot running Van Velthoven method, which was introduced to the urological community in 2003, has been adopted by many laparoscopic surgeons, as it ensures the adequate formation of the VUA and consequently a good functional outcome [7,11,12]. Other authors have promoted a single running suture in different formats [8,12,17].…”

Section: Discussionmentioning

confidence: 99%

“…The single-knot running Van Velthoven method, which was introduced to the urological community in 2003, has been adopted by many laparoscopic surgeons, as it ensures the adequate formation of the VUA and consequently a good functional outcome [7,11,12]. Other authors have promoted a single running suture in different formats [8,12,17]. Our laparoscopic single running suture technique differs from other methods because it uses a single absorbable suture placed 6 times through both the bladder neck and the urethra, with only 1 knot tied at the end of the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The Van Velthoven anastomosis is relatively complex and has an average reported completion time ranging from 18.2 to 35 min [7,11,20]. In comparison, the published completion time of the single running suture anastomosis in different modifications ranges from 9.5 to 18 min [9,12,18,21]. Although our results are statistically significant with regard to the average reduction of anastomosis time and the mean operative time for the single running suture technique, one may question their consequences to the patient and whether reducing the total procedure time by 10 min has any relevant impact on outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The Van Velthoven VUA is a commonly used technique due to its proven feasibility and safety. Despite being effective, this method is time consuming and is not free of complications [10,11,12]. In 2009, we developed an alternative technique for laparoscopic running VUA, the Chlosta's running VUA method [9].…”

Section: Introductionmentioning

confidence: 99%

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Single Running Suture versus Single-Knot Running Suture for Vesicourethral Anastomosis in Laparoscopic Radical Prostatectomy: A Prospective Randomised Comparative Study

et al. 2015

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Aim: To investigate the safety, surgical efficiency and patients' ability to recover from urinary continence as a result of a single absorbable running suture versus single-knot running suture for vesicourethral anastomosis (VUA) during laparoscopic radical prostatectomy (LRP). Material and Methods: In a prospective randomised study, we evaluated 162 consecutive patients who underwent LRP with VUA using the single running suture technique or the single-knot running suture technique. Perioperative patients' characteristics, morbidity and urinary continence were analysed. Results: The baseline characteristics were similar between the 2 groups. The single running suture technique was related to decreased anastomotic and total operative times compared with the Van Velthoven technique (13.17 ± 5.74 min vs. 28.49 ± 6.45 min, p = 0.0001, and 174.41 ± 62.97 min and 184.94 ± 46.16 min, p = 0.04, respectively). Overall, urinary continence rates at 3, 6 and 12 months in groups 1 and 2 were 49.4 and 69.1%, 81.5 and 86.4%, and 91.4 and 93.8%, respectively (all with p > 0.05 except the follow-up assessment at 3 months following surgery, p = 0.011). Conclusions: Both methods ensure satisfactory rates of urinary leakage and bladder neck stricture, as well as continence after LRP. However, since the single running suture VUA technique is easier to perform, and the mean anastomosis time of the single running suture VUA technique is shorter than that of the Van Velthoven technique, it appears, therefore, preferable.

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