Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan, USA.
J Endourol. 2010 Nov;24(11):1789-93. doi: 10.1089/end.2010.0200. Epub 2010 Jul 13.
To describe the safety and feasibility of a running urethrovesical anastomosis (UVA) in robot-assisted radical prostatectomy (RARP) using a unidirectional self-locking barbed suture.
Fifty-one consecutive patients with organ-confined prostate cancer underwent RARP by one of two experienced surgeons. UVA was performed in two layers, using a unidirectional barbed suture fashioned into a double-ended stitch. Perioperative outcomes and 30-day complications were recorded.
All anastomoses were performed without assistance and without tying a knot. Median time for entire dual-layer anastomosis was 14.0 minutes (interquartile range [IQR]: 12-20) and that for urethrovesical anastomosis was 11 minutes (IQR: 9-15). Not having to rely on an assistant to follow the suture decreased instrument clashes, entangling of the suture around an instrument, and made the anastomosis faster. Eight patients underwent anterior/lateral reconstruction of the bladder neck, and there were no leaks on cystography at 1 week.
We describe the first reported clinical experience with a novel technique of performing UVA during RARP that is safe and efficient. Using the barbed wound closure device prevents slippage, precluding the need for assistance, knot tying, and constant reassessing of anastomosis integrity.
描述在机器人辅助前列腺根治性切除术（RARP）中使用单向自锁带刺缝线进行经尿道膀胱吻合术（UVA）的安全性和可行性。
51 例局限性前列腺癌患者由两名经验丰富的外科医生之一进行 RARP。UVA 分两层进行，使用一种单向带刺缝线，形成双端缝线。记录围手术期结果和 30 天并发症。
所有吻合均无需助手协助且无需打结完成。整个双层吻合的中位时间为 14.0 分钟（四分位距 [IQR]：12-20），尿道膀胱吻合的中位时间为 11 分钟（IQR：9-15）。无需助手跟随缝线，减少了器械碰撞、缝线缠绕器械以及使吻合更快。8 例患者行膀胱颈部前侧/外侧重建，膀胱造影在 1 周时无漏尿。
我们首次报道了在 RARP 中使用一种新的 UVA 技术的临床经验，该技术安全且高效。使用带刺伤口闭合装置可防止滑脱，无需助手协助、打结和不断评估吻合完整性。
