title: Use of a barbed suture for the urethro-vesical anastomosis during the learning curve of the endoscopic extraperitoneal radical prostatectomy.
abstract: OBJECTIVE
  The performance of the urethrovesical anastomosis is one of the most difficult steps in urologic laparoscopy. Many different techniques have been developed  to improve this step and, recently, new sutures such as the V-loc (R) barbed system have been created. In the present study we analyze the usefulness of  this suture for  diminishing the time employed for the anastomosis suture during the learning curve of laparoscopic radical prostatectomy.
  
  
  METHODS
  We performed a prospective comparative study between two groups. The first group included the first 50 cases of a novel surgeon using this barbed suture, and we compared these procedures with 50 consecutives cases of an experienced surgeon. We compared  preoperative parameters, surgical and suturing times, as well as drain and catheter duration, and hospital stay.
  
  
  RESULTS
  We did not find statistically significant differences in any pre or postoperative parameters between both groups. Although surgical time was lower in the control  group this difference was not statistically significant. The time used to perform the suture was lower in the study group, and we found significant differences between both  groups. Neither drain nor bladder catheter times were different between groups.
  
  
  CONCLUSIONS
  In the absence of prospective randomized trials comparing barbed or not barbed running sutures, our study shows that the use of the V-loc® system  improves the times needed for the urethrovesical anastomosis during the learning curve of laparoscopic radical prostatectomy.
authors.affiliation: Urology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain. chimojuan@hotmail.com
authors.forename: Joaquín Ulises
authors.initials: JU
authors.lastname: Juan Escudero
authors.forename: Miguel
authors.initials: M
authors.lastname: Ramírez Backhaus
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedicto Redón
authors.forename: Macarena
authors.initials: M
authors.lastname: Ramos de Campos
authors.forename: Milagros
authors.initials: M
authors.lastname: Fabuel Deltoro
authors.forename: Pedro
authors.initials: P
authors.lastname: Navalón Verdejo
authors.forename: Emilio
authors.initials: E
authors.lastname: Marqués Vidal
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002983:Clinical Competence; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000032:analysis; D011468:Prostatectomy / Q000379:methods*; D013537:Sutures; D014521:Urethra / Q000601:surgery*; D014572:Urology / Q000193:education
chemical_list: D017430:Prostate-Specific Antigen