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Knotless laparoscopic radical prostatectomy: a preliminary experience.

Ma LL, Ye JF, Tang WH - Chin. Med. J. (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Peking University Third Hospital, Beijing 100191, China.

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Radical prostatectomy is the standard for the cure of localized prostate cancer... With the development of laparoscopic and robotic techniques, laparoscopic radical prostatectomy (LRP) or robotic-assisted radical prostatectomy (RARP) has been widely accepted with advantages of less invasiveness, shorter recovery, less blood loss, and better visualization of the operative region compared to open techniques... Under general anesthesia, the patient is put in Trendelenburg position... The working space for extraperitoneal approach is created by a cost-effective self-made balloon dilator... After the transaction of the anterior wall of the bladder, the tip of Foley catheter can be suspended to the abdominal wall in order to lift the prostate... Following the transaction of the bladder neck, the ampullary segments of the vasa deferentia could be found and the vasa deferentia are transected... The postoperative hospital stay was 6.7 ± 1.8 (5–9) days, the duration of catheter was 12.8 ± 3.6 (7–18) days... No anastomosis leakage was found... Radical prostatectomy is the standard for the cure of localized prostate cancer... With the development of the instruments, pure laparoscopic or RARP was widely adopted in different countries with advantages of less invasiveness, shorter recovery, less blood loss, and better visualization of the operative region compared to open techniques... A lot of modified van Velthoven techniques were reported using clips or barbed self-retaining suture to facilitate VUA during LRP or RARP... The mean VUA time of 19.0 minutes in knotless LRP is satisfying... The results of our modified technique are relatively satisfying... Postoperative continence is acceptable for patients... In conclusion, the modified approach of knotless LRP could be an easy and safe technique.

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Vescourethral ananstomosis. (a) First bite at 3 o’ clock. (b) Threading into the end. (c) Suturing the back wall. (d) Indwelling the catheter. (e) Complication of the UVA. F. Test for urine leakage
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Figure 2: Vescourethral ananstomosis. (a) First bite at 3 o’ clock. (b) Threading into the end. (c) Suturing the back wall. (d) Indwelling the catheter. (e) Complication of the UVA. F. Test for urine leakage

Mentions: A unidirectional single running suture is performed with a 23-cm 3-0 5/8 circle barbed self-retaining suture with one needle driver (V-Loc 90, Covidien, Mansfield, MA, USA). The first bite started at 3 o’clock and then goes clockwise [Figure 2], and the “knot” is made by threading the needle into the ending loop. The remaining sutures are the same as the single-knot LRP. No knot-tying is required for this step too.


Knotless laparoscopic radical prostatectomy: a preliminary experience.

Ma LL, Ye JF, Tang WH - Chin. Med. J. (2015)

Vescourethral ananstomosis. (a) First bite at 3 o’ clock. (b) Threading into the end. (c) Suturing the back wall. (d) Indwelling the catheter. (e) Complication of the UVA. F. Test for urine leakage
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837877&req=5

Figure 2: Vescourethral ananstomosis. (a) First bite at 3 o’ clock. (b) Threading into the end. (c) Suturing the back wall. (d) Indwelling the catheter. (e) Complication of the UVA. F. Test for urine leakage
Mentions: A unidirectional single running suture is performed with a 23-cm 3-0 5/8 circle barbed self-retaining suture with one needle driver (V-Loc 90, Covidien, Mansfield, MA, USA). The first bite started at 3 o’clock and then goes clockwise [Figure 2], and the “knot” is made by threading the needle into the ending loop. The remaining sutures are the same as the single-knot LRP. No knot-tying is required for this step too.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Peking University Third Hospital, Beijing 100191, China.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Radical prostatectomy is the standard for the cure of localized prostate cancer... With the development of laparoscopic and robotic techniques, laparoscopic radical prostatectomy (LRP) or robotic-assisted radical prostatectomy (RARP) has been widely accepted with advantages of less invasiveness, shorter recovery, less blood loss, and better visualization of the operative region compared to open techniques... Under general anesthesia, the patient is put in Trendelenburg position... The working space for extraperitoneal approach is created by a cost-effective self-made balloon dilator... After the transaction of the anterior wall of the bladder, the tip of Foley catheter can be suspended to the abdominal wall in order to lift the prostate... Following the transaction of the bladder neck, the ampullary segments of the vasa deferentia could be found and the vasa deferentia are transected... The postoperative hospital stay was 6.7 ± 1.8 (5–9) days, the duration of catheter was 12.8 ± 3.6 (7–18) days... No anastomosis leakage was found... Radical prostatectomy is the standard for the cure of localized prostate cancer... With the development of the instruments, pure laparoscopic or RARP was widely adopted in different countries with advantages of less invasiveness, shorter recovery, less blood loss, and better visualization of the operative region compared to open techniques... A lot of modified van Velthoven techniques were reported using clips or barbed self-retaining suture to facilitate VUA during LRP or RARP... The mean VUA time of 19.0 minutes in knotless LRP is satisfying... The results of our modified technique are relatively satisfying... Postoperative continence is acceptable for patients... In conclusion, the modified approach of knotless LRP could be an easy and safe technique.

Show MeSH
Related in: MedlinePlus