Use of bidirectional barbed suture for posterior muscolo-fascial reconstruction and vesico-urethral anastomosis during Robot Assisted Radical Prostatectomy (RARP)

VE33 Use of bidirectional barbed suture for posterior muscolo-fascial reconstruction and vesico-urethral anastomosis during Robot Assisted Radical Prostatectomy (RARP) Artibani W., De Marco V., Cacciamani G., Bizzotto L., De Marchi D., Cerruto M.A., Porcaro A.B., Siracusano S. Azienda Ospedaliera Universitaria Integrata, Dept. of Urology, Verona, Italy INTRODUCTION & OBJECTIVES: The barbed suture has been widely used for surgery in recent years, especially for urethrovesical anastomosis during Robot-Assisted Radical Prostatectomy (RARP). However the use of this kind of suture for the contemporary muscle-fascial reconstrucion and urethro-vesical anastomosis is still controversial. The aim is to evaluate the surgical feasibility for the contemporary muscle-facial posterior reconstruction and urethrovesical anastomosis using a single 3.0, 16 cm plus 16cm bi-directional barbed suture equipped with 17 mm needles. MATERIAL & METHODS: We employed a bi-directional suture in 53 consecutive patients who underwent RARP. In all patients muscle-fascial posterior reconstruction with a contemporary urethro-vesical anastomosis in accordance with the technique described by Rocco and Van Velthoven respectively was performed. A single 3.0 ,16 cm plus 16 cm bi-directional barbed suture equipped with needles 17 mm was utilized. RESULTS: No intraoperative and perioperative complications were observed. A satisfactory and an early recovery of urinary continence was achieved. CONCLUSIONS: Using a single 3.0 bi-directional barbed suture we were able to perform “en-bloc” muscle-fascial reconstruction and the urethro-vesical anastomis. In particular this surgical approach allowed us to ensure adequate suture tension during the entire anastomotic procedure. Functional studies in short and long-term follow-up are needed the evaluate the advantages of this anastomotic technique. The use of a single bi-directional barbed suture seems to perform posterior muscle-fascial reconstruction with the contemporary uretho-vesical anastomosis

Eur Urol Suppl 2016; 15(7):334