Comparison of leakage pressures of vesicourethral anastomosis performed with intracorporeal suturing in a simulator and conventional suturing ex vivo in canine cadaveric tissue

Abstract

Objective To compare conventional and intracorporeal vesicourethral anastomosis (VUA) in canine cadaveric tissue. Study design Cadaveric ex vivo study. Study population Twenty‐eight canine bladders with urethra. Methods Specimens after prostatectomy were randomly divided into intracorporeal (I) group or conventional (C) group. For the I group, VUA was performed in a simulator with laparoscopic needle holders and telescope. For the C group, the anastomosis was performed in vitro with standard instruments. The VUA was performed with 4–0 monofilament absorbable suture and was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and number of suture bites were recorded. Results Fourteen samples were entered in each group. The dorsal side of the anastomosis was initially performed, followed by the ventral side. The median suturing time was 30.8 minutes (range, 19.3–39.2) for the I group and 17.3 minutes (range, 9.2–21.3) for the C group (P < .0001). The median leakage pressure was 10.9 mm Hg (range, 4.1–29.7) for the I group and 10.8 mm Hg (range, 6.2–18.5) for the C group (P = .94). The median number of stitches was 20 (range, 14–26) for the I group and 19 (range, 11–28) for the C group (P = .96). The distribution of the site of leakage was similar between groups (P = .381). Conclusion Vesicourethral anastomosis can be performed with leakage pressures similar to intracorporeal and conventional suturing. Clinical significance This study represents the first step toward laparoscopic radical prostatectomy in dogs.

Influence of conventional versus unidirectional barbed suture on leakage pressures in canine vesicourethral anastomosis: An ex‐vivo study

“…Samples were immediately tested after completion of the anastomosis following a previously published technique 14,15 . An 11 cm long, 8 Fr.…”

“…Samples were immediately tested after completion of the anastomosis following a previously published technique. 14,15 An 11 cm long, 8 Fr. introducer (Super Arrow-Flex Introducer Set; Arrow International, Inc., Reading, Pennsylvania) was inserted in the urethra and secured with two circumferential sutures using 3-0 Glycomer 631 (Biosyn, Medtronic, Minneapolis).…”