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Barbed suture for renorrhaphy during robot-assisted partial nephrectomy.

Jesse Sammon1, Firas Petros, Shyam Sukumar

  • 1Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan 48202, USA. jsammon1@hfhs.org

Journal of Endourology
|March 1, 2011
PubMed
Summary

Robot-assisted partial nephrectomy (RAPN) using barbed suture for renorrhaphy is safe and efficient. This technique simplifies closure, reduces warm ischemia time, and demonstrates feasibility in human patients undergoing minimally invasive surgery.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Robot-assisted partial nephrectomy (RAPN) is a minimally invasive approach for nephron-sparing surgery.
  • Sutured renorrhaphy presents technical challenges in RAPN.
  • Barbed suture offers potential for knotless, efficient wound closure.

Purpose of the Study:

  • To evaluate the feasibility and safety of using barbed suture for renorrhaphy during RAPN.
  • To compare perioperative outcomes of barbed suture versus conventional polyglactin suture in RAPN.
  • To assess the impact of barbed suture on suturing efficiency and operative times.

Main Methods:

  • A single surgeon performed 30 consecutive RAPN procedures.
  • Fifteen patients received polyglactin suture, and 15 received barbed V-Loc 180 suture for renorrhaphy.

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  • Renorrhaphy involved two-layer closure with a sliding Hem-o-lok clip technique; outcomes were compared between groups.

    • Main Results:

    • Renorrhaphy was successfully completed in all 30 patients.
    • Warm ischemia time was significantly shorter in the barbed suture group (18.5 min vs. 24.7 min, P = 0.008).
    • No suture slippage or tearing occurred with barbed suture; clips remained secure without redundancy.

    Conclusions:

    • Barbed suture simplifies renorrhaphy during RAPN, enhancing surgical efficiency.
    • The use of barbed suture leads to reduced warm ischemia times.
    • This study demonstrates the feasibility and safety of barbed suture for renorrhaphy in minimally invasive partial nephrectomy.