Impact of newer unidirectional and bidirectional barbed suture on vesicourethral anastomosis during robot-assisted radical prostatectomy and its comparison with polyglecaprone-25 suture: an initial experience

Abstract

VUA with unidirectional barbed suture is safe and takes less time compared to monofilament suture as repeated cinching; help of assistance and knot tying are not required by virtue of its self-retaining characteristics.

Assessing the Impact of Barbed Suture on Vesicourethral Anastomosis During Minimally Invasive Radical Prostatectomy: A Systematic Review and Meta-analysis

“…Ultimately, a total of 10 studies (comprising 378 cases and 369 controls) were included in our metaanalysis. [10][11][12][13][14][15][16][17][18][19] All the studies were published within the last 4 years, reflecting the increased application of this technique. Three studies were RCTs (LE, 2b) comparing BS and conventional sutures.…”

“…Nine studies reported on postoperative urinary leak, 4 13,15,16,18 of which reported no urinary leak observed in either group. Meta-analysis of the remaining 5 studies 10,11,14,17,19 indicated no significant differences in postoperative urinary leak (OR, 0.57; 95% CI, 0.20-1.67; Bladder Neck Stricture and Anastomosis Stricture Substantial heterogeneity was observed across the set of 5 studies reporting on bladder neck stricture and anastomosis stricture, which prohibited a meta-analysis.…”

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

“…Postoperative VUA leakage is one of the most bothersome complications of radical prostatectomy, as it may result in poor anastomosis healing, urethral stricture, urinoma as well as abscess formation [3,5,6]. 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].…”

“…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.…”

“…In addition, anastomotic urinary leakage and bladder neck strictures may result in urinary retention, pelvic abscess and a delayed return of continence, complications which commonly necessitate secondary procedures [3,5,6]. In the quest for an optimal VUA, several modifications have been previously described including interrupted and running sutures [7,8,9,10,11]. A running suture is faster and easier to perform, with fewer knots required than the interrupted one [10].…”