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Technique for laparoscopic running urethrovesical anastomosis:the single knot method
Roland F Van Velthoven1, Thomas E Ahlering, Alexandre Peltier
1Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
Urology
|April 3, 2003
Summary
A new laparoscopic technique simplifies urethrovesical anastomosis during radical prostatectomy. This running suture method ensures a watertight connection, reducing complications like urinary leaks and bladder neck contractures.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Radical prostatectomy for prostate cancer requires precise urethrovesical anastomosis.
- Minimally invasive laparoscopic approaches present unique challenges for this critical step.
Purpose of the Study:
- To present a novel, simplified technique for urethrovesical anastomosis during laparoscopic radical prostatectomy.
- To demonstrate the efficacy and safety of this running suture method.
Main Methods:
- Utilized two 6-inch polyglycolic acid sutures, tied together and introduced via a 12-mm port.
- Performed a running suture anastomosis from 6:30 to 12:00 and 5:30 to 12:00 o'clock positions, completing with an intracorporeal tie.
- Placed a urinary catheter before anterior suture completion, leaving it for 5-7 days.
Main Results:
- Successfully applied in 122 laparoscopic radical prostatectomies and 8 robot-assisted procedures.
- Achieved an average anastomosis time of 35 minutes (range 14-80 minutes).
- All anastomoses were watertight, with no symptomatic postoperative urinary leaks or bladder neck contractures.
Conclusions:
- A simple, watertight, running laparoscopic suture technique for urethrovesical anastomosis has been developed.
- This method facilitates efficient and safe reconstruction during laparoscopic radical prostatectomy.