Does the use of a barbed polyglyconate absorbable suture have an impact on urethral anastomosis time, urethral stenosis rates, and cost effectiveness during robot-assisted radical prostatectomy?

Urology. 2013 Jul;82(1):90-4. doi: 10.1016/j.urology.2013.02.002.

Abstract

Objective: To evaluate the use of a single needle driver with the V-Loc (Covidien, Dublin, Ireland) running suture and compare this with the use of 2 needle drivers with polyglactin interrupted sutures (IS) in dividing the dorsal venous complex (DVC) and forming the urethrovesical anastomosis (UVA) during robot-assisted radical prostatectomy (RARP).

Materials and methods: A prospective cohort study was performed to compare V-Loc (n = 40) with polyglactin (n = 40) sutures. Division of the dorsal venous complex and formation of the UVA during robot-assisted radical prostatectomy using V-Loc or polyglactin sutures were studied. Preoperative, intraoperative, and postoperative parameters were measured.

Results: V-Loc sutures were associated with a statistically significant reduction in mean dorsal vein suture time (3.15 minutes V-Loc vs 3.75 minutes IS, P = .02) and UVA anastomosis time (8.5 minutes V-Loc vs 11.5 minutes IS, P = .001). No significant difference was noted between operative time (121 minutes V-Loc vs 130 minutes IS, P = .199), delayed healing rates (5% V-Loc vs 7.5% IS, P = .238), continence rate at 12 months (97.5% V-Loc vs 95% IS, P = .368), and urethral stenosis rates (2.5% V-Loc vs 2.5% IS, P = .347) in both groups.

Conclusion: The use of a V-Loc running suture with a single needle driver is a feasible, reproducible, and economic technique with no significant difference in continence rates and urethral stenosis rates, compared with the use of a traditional interrupted suture.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / instrumentation
  • Cost-Benefit Analysis
  • Equipment Design
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Polymers
  • Prostatectomy / adverse effects
  • Prostatectomy / economics
  • Robotics
  • Suture Techniques / instrumentation*
  • Sutures* / adverse effects
  • Sutures* / economics
  • Urethra / surgery*
  • Urethral Stricture / etiology
  • Urinary Bladder / surgery*
  • Urinary Incontinence / etiology
  • Veins / surgery*
  • Wound Healing

Substances

  • Polymers
  • polyglyconate