title: [Bidirectional barbed suture for bladder neck reconstruction, posterior reconstruction and vesicourethral anastomosis during robot assisted radical prostatectomy].
abstract: BACKGROUND
  The urethrovesical anastomosis is a particular challenging step of robot assisted radical prostatectomy (RARP). Failure to achieve a watertight anastomosis is associated with postoperative urinary leak and its consequences, which include paralytic ileus, prolonged catheterization, urinary peritonitis and possibly re-intervention. The bidirectional barbed suture is a new technology that may lead to improve the quality of the urethrovesical anastomosis.
  
  
  OBJECTIVE
  To present our surgical technique of urethrovesical anastomosis, bladder neck reconstruction and posterior reconstruction, using a bidirectional barbed suture.
  
  
  METHODS
  The bladder neck reconstruction, posterior reconstruction and vesicourethral anastomosis were performed using a 2-0 synthetic absorbable bidirectional monofilament barbed suture
  
  
  RESULTS
  All cases were finished successfully without major complication or conversion to laparoscopic or open surgery.
  
  
  CONCLUSIONS
  The authors successfully modified their RARP technique to take advantage of the properties of the bidirectional barbed suture. Comparative studies that evaluate objective outcomes such as leakage rates and operative time are needed to definitely establish the benefits of this device in comparison to the traditional absorbable monofilament.
authors: Instituto de Robótica Global, Hospital Celebration Health de Florida, Celebration, Florida, USA. rairvalero@gmail.com
authors: R
authors: R
authors: Valero
authors: O
authors: O
authors: Schatloff
authors: S
authors: S
authors: Chauhan
authors: Y
authors: Y
authors: HwiiKo
authors: A
authors: A
authors: Sivaraman
authors: R F
authors: RF
authors: Coelho
authors: K J
authors: KJ
authors: Palmer
authors: H
authors: H
authors: Davila
authors: V R
authors: VR
authors: Patel
mesh_terms: D000714:Anastomosis, Surgical; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012371:Robotics; D013536:Suture Techniques; D013537:Sutures; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery*