Use of a novel absorbable barbed plastic surgical suture enables a "self-cinching" technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times.
OBJECTIVE
To demonstrate a novel technique of self-cinching anastomosis using a barbed and looped suture during robot-assisted radical prostatectomy (RARP).


METHODS
This is a feasibility study of 50 consecutive patients who underwent this novel self-cinching anastomotic technique using a V-Loc™ 180 absorbable barbed suture after RARP for clinically localized prostate cancer. The results were then compared with 50 consecutive patients who underwent RARP by the same surgeon before this new technique. We examined whether this novel technique had any effects on posterior reconstruction time, vesicourethral anastomosis time, and thus total reconstruction and operative time by inference.


RESULTS
The V-Loc 180 group had significantly shorter posterior reconstruction (40 seconds vs 60 seconds; P ≤ 0.001) and vesicourethral anastomotic times (7 min vs 12 min; P ≤ 0.001). By inference, this meant that total reconstruction and operative times were also significantly less (8 minutes vs 13.5 min; P ≤ 0.001 and 106 min vs 114.5 minutes; P ≤ 0.001, respectively).


CONCLUSIONS
We have shown that this technique is feasible and improves posterior reconstruction and anastomotic times. Further follow-up will determine any benefits of this technique on anastomotic urinary leak rates, continence, and catheter removal times.
Tewari
Ashutosh K
AK
LeFrak Center of Robotic Surgery and Institute of Prostate Cancer, James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York 10065, USA. ashtewarimd@gmail.com
Srivastava
Abhishek
A
Sooriakumaran
Prasanna
P
Slevin
Adam
A
Grover
Sonal
S
Waldman
Olivia
O
Rajan
Sivaram
S
Herman
Michael
M
Berryhill
Roy
R
Leung
Robert
R
D000714:Anastomosis, Surgical / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D012371:Robotics; D013537:Sutures; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*