Laparoscopic Anastomoses and Bladder Neck Reconstruction Following Radical Prostatectomy

  • Ender Özden
  • Özcan Kiliç
  • Ali Serdar Gözen
  • Dogu Teber
  • Jens RassweilerEmail author
Part of the Current Clinical Urology book series (CCU)


Laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy have gained increasing importance in the urologic oncology field and have become an established treatment for localized prostate cancer [1–3]. The goals in both open and laparoscopic radical prostatectomy are lifelong oncologic control of localized prostate carcinoma while maintaining continence and potency functions with minimization of operative morbidity that contribute to a global quality of life. Vesicourethral anastomosis is a critical step during laparoscopic prostatectomy with major implications for anastomotic leak and ultimately continence.


Laparoscopy Ergonomics LESS NOTES Navigation Image-guided surgery 

Supplementary material

Laparoscopic Vesicourethral Anastomosis and Bladder Neck Reconstruction Following Laparoscopic Radical Prostatectomy (41.1 MB)


  1. 1.
    Laguna MP, Schreuders LC, Rassweiler JJ, Abbou CC, van Velthoven R, Janetschek G, Breda G, de la Rosette JJ. European Society of Uro-Technology. Development of laparoscopic surgery and training facilities in Europe: results of a survey of the European Society of Uro-Technology (ESUT). Eur Urol. 2005;47:346–51.PubMedCrossRefGoogle Scholar
  2. 2.
    Rassweiler J, Stolzenburg J, Sulser T, Deger S, Zumbe J, Hofmockel G, John H, Janetschek G, Fehr JL, Hatzinger M, Probst M, Rothenberger KH, Poulakis V, Truss M, Popken G, Westphal J, Alles U, Fornara P. Laparoscopic radical prostatectomy – the experience of the German Laparoscopic Working Group. Eur Urol. 2006;49:113–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A, Hemal AK. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am. 2004;31:701–17.PubMedCrossRefGoogle Scholar
  4. 4.
    Frede T, Erdogru T, Zukosky D, Gulkesen H, Teber D, Rassweiler J. Comparison of training modalities for performing laparoscopic radical prostatectomy: experience with 1,000 patients. J Urol. 2005;174:673–8; discussion 678.PubMedCrossRefGoogle Scholar
  5. 5.
    Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology. 1997;50:854–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Teber D, Cresswell J, Ates M, Erdogru T, Hruza M, Gozen AS, Rassweiler J. Laparoscopic radical prostatectomy in clinical T1a and T1b prostate cancer: oncologic and functional outcomes-a matched-pair analysis. Urology. 2009;73:577–81.PubMedCrossRefGoogle Scholar
  7. 7.
    Srougi M, Paranhos M, Leite KM, Dall’Oglio M, Nesrallah L. The influence of bladder neck mucosal eversion and early urinary extravasation on patient outcome after radical retropubic prostatectomy: a prospective controlled trial. BJU Int. 2005;95:757–60.PubMedCrossRefGoogle Scholar
  8. 8.
    Rocco F, Carmignani L, Acquati P, Gadda F, Dell’Orto P, Rocco B, Bozzini G, Gazzano G, Morabito A. Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy. J Urol. 2006;175:2201–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Garrett JE, LaGrange CA, Chenven E, Strup SE. Use of Lowsley tractor during laparoscopic prostatectomy to reduce urethrovesical anastomotic tension. J Endourol. 2006;20:220–2.PubMedCrossRefGoogle Scholar
  10. 10.
    Kondo Y, Matsuzawa I, Watanabe J, Hamasaki T, Yoshida K, Nishimura T. Utility of extracorporeal traction with nylon thread for easier vesicourethral anastomosis in laparoscopic prostatectomy. Int J Urol. 2005;12:1082–4.PubMedCrossRefGoogle Scholar
  11. 11.
    Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol. 2000;163:1643–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Hoznek A, Salomon L, Rabii R, Ben Slama MR, Cicco A, Antiphon P, Abbou CC. Vesicourethral anastomosis during laparoscopic radical prostatectomy: the running suture method. J Endourol. 2000;14:749–53.PubMedCrossRefGoogle Scholar
  13. 13.
    Rassweiler J, Sentker L, Seemann O, Hatzinger M, Rumpelt HJ. Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol. 2001;166:2101–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV. Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. 2003;61:699–702.PubMedCrossRefGoogle Scholar
  15. 15.
    Menon M, Hemal AK, Tewari A, Shrivastava A, Bhandari A. The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. BJU Int. 2004;93:715–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Curto F, Benijts J, Pansadoro A, Barmoshe S, Hoepffner JL, Mugnier C, Piechaud T, Gaston R. Nerve sparing laparoscopic radical prostatectomy: our technique. Eur Urol. 2006;49:344–52.PubMedCrossRefGoogle Scholar
  17. 17.
    Emiliozzi P, Martini M, d‘Elia G, Scarpone P, Pansadoro A, Pansadoro V. A new technique for laparoscopic vesicourethral anastomosis: preliminary report. Urology. 2008;72:1341–3.PubMedCrossRefGoogle Scholar
  18. 18.
    Branco AW, Kondo W, de Camargo AH, Branco Filho AJ, de George MA, Stunitz LC. Laparoscopic running urethrovesical anastomosis with posterior fixation. Urology. 2007;70:799–802.PubMedCrossRefGoogle Scholar
  19. 19.
    Shichiri Y, Kanno T, Oida T, Kanamaru H. Facilitating the technique of laparoscopic running urethrovesical anastomosis using Lapra-Ty absorbable suture clips. Int J Urol. 2006;13:192–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Ramani AP, Braasch M, Monga M, Ryndin I, Botnaru A. Novel device to assist urethrovesical anastomosis during laparoscopic radical prostatectomy. Urology. 2005;66:1099–100.PubMedCrossRefGoogle Scholar
  21. 21.
    Hoznek A, Salomon L, Olsson LE, Antiphon P, Saint F, Cicco A, Chopin D, Abbou CC. Laparoscopic radical prostatectomy. The Creteil experience. Eur Urol. 2001;40:38–45.PubMedCrossRefGoogle Scholar
  22. 22.
    Guillonneau B, Cathelineau X, Doublet JD, Vallancien G. Laparoscopic radical prostatectomy: the lessons learned. J Endourol. 2001;15:441–5; discussion 447–8.PubMedCrossRefGoogle Scholar
  23. 23.
    Eden CG, Cahill D, Vass JA, Adams TH, Dauleh MI. Laparoscopic radical prostatectomy: the initial UK series. BJU Int. 2002;90:876–82.PubMedCrossRefGoogle Scholar
  24. 24.
    Gill IS, Zippe CD. Laparoscopic radical prostatectomy: technique. Urol Clin North Am. 2001;28:423–36.PubMedCrossRefGoogle Scholar
  25. 25.
    Kenngott HG, Müller-Stich BP, Reiter MA, Rassweiler JJ, Gutt CN. Robotic suturing: technique and benefit in advanced laparoscopic surgery. Minim Invasive Ther. 2008;17:160–7.CrossRefGoogle Scholar
  26. 26.
    Frede T, Stock C, Rassweiler JJ, Alken P. Retroperitoneoscopic and laparoscopic suturing: tips and strategies for improving efficiency. J Endourol. 2000;14:905–13; discussion 913–4.PubMedCrossRefGoogle Scholar
  27. 27.
    Guillonneau B, Rozet F, Cathelineau X, Lay F, Barret E, Doublet JD, Baumert H, Vallancien G:. Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol. 2002;167:51–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Nadu A, Salomon L, Hoznek A, Olsson LE, Saint F, de La Taille A, Cicco A, Chopin D, Abbou CC. Early removal of the catheter after laparoscopic radical prostatectomy. J Urol. 2001;166:1662–4.PubMedCrossRefGoogle Scholar
  29. 29.
    Turk I, Deger S, Winkelmann B, Schonberger B, Loening SA. Laparoscopic radical prostatectomy. Technical aspects and experience with 125 cases. Eur Urol. 2001;40:46–52; discussion 53.PubMedCrossRefGoogle Scholar
  30. 30.
    van Velthoven RF, Mottrie AM, Abbou CC, Erdoğru T, Teber D, Rassweiler JJ, Menon M, Gill IS, Ahlering TE. International multicentric survey about 4558 vesicourethral anastomosis after laparoscopic radical prostatectomy. J Endourol. 2006;20(Suppl 1):MP29–18.Google Scholar
  31. 31.
    Gonzalgo ML, Pavlovich CP, Trock BJ, Link RE, Sullivan W, Su LM. Classification and trends of perioperative morbidities following laparoscopic radical prostatectomy. J Urol. 2005;174:135–9; discussion 139.PubMedCrossRefGoogle Scholar
  32. 32.
    Msezane LP, Reynolds WS, Gofrit ON, Shalhav AL, Zagaja GP, Zorn KC. Bladder neck contracture after robot-assisted laparoscopic radical prostatectomy: evaluation of incidence and risk factors and impact on urinary function. J Endourol. 2008;22:377–83.PubMedCrossRefGoogle Scholar
  33. 33.
    Teber D, Erdogru T, Cresswell J, Gozen AS, Frede T, Rassweiler JJ. Analysis of three different vesicourethral anastomotic techniques in laparoscopic radical prostatectomy. World J Urol. 2008;26:617–22.PubMedCrossRefGoogle Scholar
  34. 34.
    Sugiono M, Teber D, Anghel G, Gozen AS, Stock C, Hruza M, Frede T, Klein J, Rassweiler JJ. Assessing the predictive validity and efficacy of a multimodal training programme for laparoscopic radical prostatectomy (LRP). Eur Urol. 2007;51:1332–9; discussion 1340.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Ender Özden
    • 1
  • Özcan Kiliç
    • 1
  • Ali Serdar Gözen
    • 2
  • Dogu Teber
    • 2
  • Jens Rassweiler
    • 2
    Email author
  1. 1.SLK-Klinikum Heilbronn, University of HeidelbergHeilbronnGermany
  2. 2.Department of UrologySLK-Klinikum Heilbronn, University of HeidelbergHeilbronnGermany

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