Facilitating the technique of laparoscopic running urethrovesical anastomosis using Lapra-ty absorbable suture clips

We herein describe a simplified technique for performing laparoscopic running urethrovesical anastomosis using Lapra-ty absorbable suture clips (Ethicon, Somerville, NJ, USA) during a laparoscopic radical prostatectomy (LRP). Using two 20 cm absorbable sutures tied together and locked with Lapra-ty at their tail ends, the initiating mattress sutures are placed in the 5:30-6:30-o'clock area between the urethra and the bladder neck. The left and right running sutures are then made clockwise from the 6:30-12-o'clock position and counterclockwise from the 5:30-12-o'clock position, respectively. Both sutures are locked with proper tension by Lapra-ty at the 3, 9 and 12-o'clock positions, and then they are intracorporeally tied together just at the 12-o'clock position. In the initial 20 cases, this anastomosis took 22.5 min on average to perform. We experienced no major urine extravasation and no anastomotic stricture to date.