Valero R, Schatloff O, Chauhan S, HwiiKo Y, Sivaraman A, Coelho R F, Palmer K J, Davila H, Patel V R
Instituto de Robótica Global, Hospital Celebration Health de Florida, Celebration, Florida, USA.
Actas Urol Esp. 2012 Feb;36(2):69-74. doi: 10.1016/j.acuro.2011.06.010. Epub 2011 Sep 1.
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.
To present our surgical technique of urethrovesical anastomosis, bladder neck reconstruction and posterior reconstruction, using a bidirectional barbed suture.
The bladder neck reconstruction, posterior reconstruction and vesicourethral anastomosis were performed using a 2-0 synthetic absorbable bidirectional monofilament barbed suture
All cases were finished successfully without major complication or conversion to laparoscopic or open surgery.
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.
尿道膀胱吻合术是机器人辅助根治性前列腺切除术（RARP）中一个特别具有挑战性的步骤。未能实现水密吻合与术后尿漏及其后果相关，这些后果包括麻痹性肠梗阻、导尿时间延长、尿性腹膜炎以及可能需要再次干预。双向倒刺缝线是一种可能有助于提高尿道膀胱吻合质量的新技术。
介绍我们使用双向倒刺缝线进行尿道膀胱吻合术、膀胱颈重建和后重建的手术技术。
使用2-0合成可吸收双向单丝倒刺缝线进行膀胱颈重建、后重建和膀胱尿道吻合术。
所有病例均成功完成，无重大并发症，也无需转为腹腔镜手术或开放手术。
作者成功地改进了他们的RARP技术，以利用双向倒刺缝线的特性。需要进行评估诸如漏尿率和手术时间等客观结果的比较研究，以明确确定该装置相对于传统可吸收单丝缝线的优势。
