TY - JOUR
T1 - Use of the laparoscopic knot introducer in urethrovesical anastomosis following radical prostatectomy
AU - Cestari, A.
AU - Guazzoni, G.
AU - Riva, M.
AU - Nava, L.
AU - Rigatti, P.
PY - 1999
Y1 - 1999
N2 - One of the most delicate stages of retropubic radical prostatectomy intervention is urethrovesical anastomosis, especially if it is performed in a deep bony pelvis with a short urethral stump. Correct knot tying is essential to avoid the risk of postoperative anastomotic leakage. In such conditions, the urethrovesical anastomosis is performed with six 4-0 Monocril sutures and the knots are tied under vision using the laparoscopic knot introducer. In a 2-year period we performed 106 retropubic radical prostatectomies in our urology department. In four cases (3.8%) we performed urethrovesical anastomosis with the aid of the described technique. Two weeks after catheter placement, the radiologic control showed no leakage or contracture of the anastomosis. Mean follow-up is 14.8 months (range 8 to 20); all of the patients are continent. A second radiologic study 6 months after the intervention documented in all cases a correct new anatomical repair without stenoses or contracture. This technique is a minor modification of the direct urethrovesical anastomosis that facilitates the anastomosis between the urethral stump and the bladder neck and reduces the risk of anastomotic leakage due to incorrect suture knot positioning and tying.
AB - One of the most delicate stages of retropubic radical prostatectomy intervention is urethrovesical anastomosis, especially if it is performed in a deep bony pelvis with a short urethral stump. Correct knot tying is essential to avoid the risk of postoperative anastomotic leakage. In such conditions, the urethrovesical anastomosis is performed with six 4-0 Monocril sutures and the knots are tied under vision using the laparoscopic knot introducer. In a 2-year period we performed 106 retropubic radical prostatectomies in our urology department. In four cases (3.8%) we performed urethrovesical anastomosis with the aid of the described technique. Two weeks after catheter placement, the radiologic control showed no leakage or contracture of the anastomosis. Mean follow-up is 14.8 months (range 8 to 20); all of the patients are continent. A second radiologic study 6 months after the intervention documented in all cases a correct new anatomical repair without stenoses or contracture. This technique is a minor modification of the direct urethrovesical anastomosis that facilitates the anastomosis between the urethral stump and the bladder neck and reduces the risk of anastomotic leakage due to incorrect suture knot positioning and tying.
KW - Prostate cancer
KW - Radical prostatectomy
KW - Urethrovesical anastomosis
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M3 - Article
C2 - 10527259
AN - SCOPUS:0032757572
VL - 5
SP - 152
EP - 154
JO - Techniques in Urology
JF - Techniques in Urology
SN - 1079-3259
IS - 3
ER -