New method of urethravesical anastomosis during laparoscopic radical prostaectomies with V-Loc

Apolihin O.I., Chernyshev I.V., Abdullin I.I., Keshishev N.G., Gurbanov Sh.Sh., Prosyannikov M.Yu.

Introduction: Watertightness of UVA is still most challenging stage of LRP. Fail to provide full watertightness may provide urinary leakage, prolonged urethral catheterization, long hospitalization and result in incontinence and/or stricture of UVA. Usually lapsurgeons use one of techniques: interrupted or continuous.

Purpose: Our purpose was to evaluate benefits of new technique of UVA perfomance

Material and Methods: From November 2010 till February 2012 75 patients with organ-confined prostate cancer underwent LRP. All patients were divided into 3 groups depending on type of UVA performance. 1 group – interrupted suture with monocryl 3-0, 2 group – running 2 needles technique and 3 group – running V-Loc suture. Perioperative outcomes and yearly postoperative period were compared.

Results: Average time of UVA formation in 1 Group was 82 ± 15 min, in 2 Group 74 ± 13 min and 3 Group 32 ± 6 min (p< 0,05). Urinary leakage in 1 Group was 6 (17%) patients, in 2 Group 3 (16%) patients and in 3 Group 0 (%). Duration of catheter drainage in 1 Group 9,8 ± 2,3 days, 2 Group 8,3 ±2,1 days and 3 Group 5± 1,2 (p< 0,05), Length of hospitalization in 1 Group was 10,3± 3,0 days, in 2 Group 9,6±2,5 days and in 3 Group 7± 1,8 (p< 0,05).

Conclusion: V-Loc suture is safe and effective instrument of UVA performance. It makes LRP more feasible and more easy to train. We believe that implementation of this technique can shorten learning curve for LRP and encourage more urologist in favour this procedure.

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