Techniques in Endourology Vesicourethral Anastomosis During Laparoscopic Radical Prostatectomy: The Running Suture Method

Hoznek, Andràs; Salomon, Laurent; Rabii, R.; Slama, Mohamed-Riadh Ben; Cicco, Antony; Antiphon, Patrick; Abbou, Clément‐Claude

doi:10.1089/end.2000.14.749

Cited by 82 publications

(38 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laparoscopic radical prostatectomy usually includes a single knot with continuous running vesicourethral anastomosis [10]. This technique simplifies laparoscopic radical prostatectomy, as it is easy to learn and perform, is watertight, and appears to have a low risk of bladder neck constriction.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The single-knot method with Lapra-Ty clips is useful for training surgeons in vesicourethral anastomosis during laparoscopic radical prostatectomy

et al. 2008

View full text Add to dashboard Cite

We determined the applicability of the running single-knotted suture with Lapra-Ty clips to locking the vesicourethra at the 6 o'clock position for teaching anastomosis during laparoscopic radical prostatectomy to trainee surgeons. Fifty consecutive patients underwent laparoscopic radical prostatectomy for prostate cancer conducted by five surgeons with no experience of this procedure. Twenty (group 1) and 30 (group 2) of the patients underwent vesicourethral anastomosis using the single-knot running technique without or with Lapra-Ty clips. Surgical data, duration of surgical anastomosis, extravasation rate, time until healing and catheter removal, and occurrence of anastomotic structures were evaluated. The duration of surgical anastomosis was significantly greater without than with the Lapra-Ty clips (56 +/- 13 min versus 45 +/- 10 min, P < 0.01). The extravasation rate on postoperative cystography was significantly higher without than with the Lapra-Ty clips (30.0% versus 10.0%, P < 0.05). Leakage occurred on the 6 o'clock side of the anastomosis in all of these patients and urinary retention occurred in one patient (5.0%) in group 1. The single-knot method with Lapra-Ty clips in vesicourethral anastomosis during laparoscopic radical prostatectomy is useful, safe, and efficient, especially for surgeons learning the technique.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Interrupted [7,8] and continuous single-knot [9,10] sutures comprise the current standardized vesicourethral anastomosis techniques for laparoscopic radical prostatectomy. The use of continuously single-knotted sutures is increasing because it is a simpler procedure and the surgical duration is shorter [11].…”

Section: Introductionmentioning

confidence: 99%

The single-knot method with Lapra-Ty clips is useful for training surgeons in vesicourethral anastomosis during laparoscopic radical prostatectomy

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Initially, it was considered to be the most difficult part of the procedure [29]. Subsequently, many centers developed their own standardized laparoscopic technique for urethrovesical anastomosis [30]. Preliminary models for the laparoscopic radical prostatectomy and the urethrovesical anastomosis have used the canine model [11].…”

Section: Specific Urologic Models: the Vesicourethral Anastomosismentioning

confidence: 99%

Laparoscopic and robotic surgical training in urology

Hoznek

Katz²,

Gettman³

et al. 2003

Curr Urol Rep

Self Cite

View full text Add to dashboard Cite

The most important change in urology during the past decade was the development of minimally invasive surgery, particularly laparoscopy. However, the main drawback of laparoscopy is a steep learning curve, which results from the significant changes in the surgical environment. Although laparoscopy can provide important advantages for the patient, including decreased length of hospitalization, decreased analgesic requirement, and a shortened postoperative convalescence, one concern has been whether laparoscopic techniques should be learned solely in the operating room. For example, sports, music, and aviation are practiced before an actual performance is ever undertaken. In this review, the advantages and limitations of all available training modalities in minimally invasive surgery are described. Testing basic laparoscopic skills on inanimate models, becoming familiar with the principles of dissection and hemostasis on living animals, and studying surgical anatomy on cadavers should be considered as indispensable and complementary elements for laparoscopic training in the future. In addition, telementoring with the help of modern image processing and virtual reality eventually may become the basis of tomorrow's surgical instruction.

show abstract

“…Consequently, open prostatectomy is associated with a prolonged catheterization period of 2 -3 weeks. Comparatively, during laparoscopic radical prostatectomy all sutures are meticulously placed and each is tied under complete visual control, resulting in a precise mucosa-to-mucosa approximation (17).…”

Section: Urethro-vesical Anastomosis -Impact Over Postoperative Contimentioning

confidence: 99%

Pertinent issues related to laparoscopic radical prostatectomy

Abreu

Gill

2003

Int. braz j urol.

View full text Add to dashboard Cite

Purpose: We describe the critical steps of the laparoscopic radical prostatectomy (LRP) technique and discuss how they impact upon the pertinent issues regarding prostate cancer surgery: blood loss, potency and continence.Results: A major advantage of LRP is the reduced operative blood loss. The precise placement of the dorsal vein complex stitch associated with the tamponading effect of the CO 2 pneumoperitoneum significantly decrease venous bleeding, which is the main source of blood loss during radical prostatectomy. At the Cleveland Clinic, the average blood loss of our first 100 patients was 322.5 ml, resulting in low transfusion rates.The continuous venous bleeding narrowed pelvic surgical field and poor visibility can adversely impact on nerve preservation during open radical prostatectomy. Laparoscopy, with its enhanced and magnified vision in a relatively bloodless field allows for excellent identification and handling of the neurovascular bundles.During open retropubic radical prostatectomy, the pubic bone may impair visibility and access to the urethral stump, and the surgeon must tie the knots relying on tactile sensation alone. Consequently, open prostatectomy is associated with a prolonged catheterization period of 2 -3 weeks. Comparatively, during laparoscopic radical prostatectomy all sutures are meticulously placed and each is tied under complete visual control, resulting in a precise mucosa-to-mucosa approximation.Conclusion: The laparoscopic approach may represent a reliable less invasive alternative to the conventional open approach. Despite the encouraging preliminary anatomical and functional outcomes, prospective randomized comparative trials are required to critically evaluate the role of laparoscopy for this sophisticated and delicate operation.

show abstract

Techniques in Endourology Vesicourethral Anastomosis During Laparoscopic Radical Prostatectomy: The Running Suture Method

Cited by 82 publications

References 5 publications

The single-knot method with Lapra-Ty clips is useful for training surgeons in vesicourethral anastomosis during laparoscopic radical prostatectomy

The single-knot method with Lapra-Ty clips is useful for training surgeons in vesicourethral anastomosis during laparoscopic radical prostatectomy

Laparoscopic and robotic surgical training in urology

Pertinent issues related to laparoscopic radical prostatectomy

Contact Info

Product

Resources

About