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Minerva Urologica e Nefrologica 2018 Jan 29

DOI: 10.23736/S0393-2249.18.02969-7


lingua: Inglese

Single barbed bidirectional suture for posterior muscle-fascial reconstruction and knotless urethro-vescical anastomosis during Robot-assisted radical prostatectomy

Angelo PORRECA 2, Daniele D’AGOSTINO 2 , Matteo DANDREA 2, Antonio SALVAGGIO 2, Alessandro DEL ROSSO 2, Emanuele CAPPA 2, Alessio ZUCCALÀ 2, Daniele ROMAGNOLI 2 Lorenzo BIANCHI 1, Riccardo SCHIAVINA 1

1 Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 2 Department of Urology, Policlinic of Abano Terme, Abano Terme, Padua, Italy


BACKGROUND: The aim of the work is to describe an original technique of posterior muscle-fascial reconstruction (PMFR) during Robot-assisted radical prostatectomy (RARP).
METHODS: From January 2015 to June 2016, 121 consecutives patients underwent RARP and were submitted to a novel tecnique of PMFR, using a single 3/0 barbed bi-directional (Filblock ® - Assut Europe) suture. The first step of this new technique of PMFR, is to approximate the posterior layer of Denonvilliers fascia (DF) to the posterior part of the sphinteric apparatus. Then, the second step consists in the anastomosis of the posterior blabber neck edge with the posterior urethra edge. We realize the completion of anastomosis clockwise from h 7 to h 12 and anticlockwise from h 5 to h 12.
RESULTS: No leakage of anastomosis were observed and the catheter was removed in the 5th day after surgery. After catheter removal, the urinary recovery of early continence at 3 days was 45% and at 7 days was 75%, while the urinary continence recovery at 1 month was 88% and at 3 months was 94%.
CONCLUSIONS: In our experience this novel approach results feasible in all patient, without extending the operation time and gives a good safety in terms of reduction of bleeding and leakage with shorter urinary continence recovery's time. The aim of the combination of the muscolofascial reconstruction and the urethrovescical anastomosis with one bidirectional barbed suture is to have all the advantages of both techniques plus the stability of a single running suture.

KEY WORDS: Barbed suture - Urethrovescical anastomosis - Robotic radical prostatectomy

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Publication History

Article first published online: January 29, 2018
Manuscript accepted: January 15, 2018
Manuscript revised: December 22, 2017
Manuscript received: May 9, 2017

Per citare questo articolo

Porreca A, Dandrea M, Salvaggio A, Del Rosso A, Cappa E. Single barbed bidirectional suture for posterior muscle-fascial reconstruction and knotless urethro-vescical anastomosis during Robot-assisted Radical Prostatectomy. Minerva Urol Nefrol 2018 Jan 29. DOI: 10.23736/S0393-2249.18.02969-7

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