Skip to main content
SpringerLink
Log in

The single-knot method with Lapra-Ty clips is useful for training surgeons in vesicourethral anastomosis during laparoscopic radical prostatectomy

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

We determined the applicability of the running single-knotted suture with Lapra-Ty clips to locking the vesicourethra at the 6 o’clock position for teaching anastomosis during laparoscopic radical prostatectomy to trainee surgeons. Fifty consecutive patients underwent laparoscopic radical prostatectomy for prostate cancer conducted by five surgeons with no experience of this procedure. Twenty (group 1) and 30 (group 2) of the patients underwent vesicourethral anastomosis using the single-knot running technique without or with Lapra-Ty clips. Surgical data, duration of surgical anastomosis, extravasation rate, time until healing and catheter removal, and occurrence of anastomotic structures were evaluated. The duration of surgical anastomosis was significantly greater without than with the Lapra-Ty clips (56 ± 13 min versus 45 ± 10 min, P < 0.01). The extravasation rate on postoperative cystography was significantly higher without than with the Lapra-Ty clips (30.0% versus 10.0%, P < 0.05). Leakage occurred on the 6 o’clock side of the anastomosis in all of these patients and urinary retention occurred in one patient (5.0%) in group 1. The single-knot method with Lapra-Ty clips in vesicourethral anastomosis during laparoscopic radical prostatectomy is useful, safe, and efficient, especially for surgeons learning the technique.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR (1997) Laparoscopic radical prostatectomy: initial short-term experience. Urology 50:854–857

    Article  PubMed  CAS  Google Scholar 

  2. Abbou CC, Salomon L, Hoznek A, Antiphon P, Cicco A, Saint F, Alame W, Bellot J, Chopin DK (2000) Laparoscopic radical prostatectomy: preliminary results. Urology 55:630–634

    Article  PubMed  CAS  Google Scholar 

  3. Guillonneau B, Cathelineau X, Doublet JD, Vallancien G (2001) Laparoscopic radical prostatectomy: the lessons learned. J Endourol 15:441–448

    Article  PubMed  CAS  Google Scholar 

  4. Poulakis V, Dillenburg W, Moeckel M, de Vries R, Witzsch U, Zumbe J, Rassweiler J, Becht E (2005) Laparoscopic radical prostatectomy: prospective evaluation of the learning curve. Eur Urol 47:167–175

    Article  PubMed  Google Scholar 

  5. Teber D, Dekel Y, Frede T, Klein J, Rassweiler J (2005) The Heilbronn laparoscopic training program for laparoscopic suturing: concept and validation. J Endourol 19:230–238

    Article  PubMed  Google Scholar 

  6. Surya BV, Provet J, Johanson KE, Brown J (1990) Anastomotic strictures following radical prostatectomy: risk factors and management. J Urol 143:755–758

    PubMed  CAS  Google Scholar 

  7. Guillonneau B, Vallancin G (2000) Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 163:1643–1649

    Article  PubMed  CAS  Google Scholar 

  8. Stolzenburg JU, Do M, Pfeiffer H, Konig F, Aedtner B, Dorschner W (2002) The endoscopic extraperitoneal radical prostatectomy (EERPE): technique and initial experience. World J Urol 20:48–55

    Article  PubMed  Google Scholar 

  9. Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV (2003) Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology 61:699–702

    Article  PubMed  Google Scholar 

  10. Hoznek A, Salomon L, Rabii R, Ben Slama MR, Cicco A, Antiphon P, Abbou CC (2000) Vesicourethral anastomosis during laparoscopic radical prostatectomy: the running suture method. J Endourol 14:749–753

    Article  PubMed  CAS  Google Scholar 

  11. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Witzsch U, Becht E (2006) Vesicourethral anastomosis during endoscopic extraperitoneal radical prostatectomy: a prospective comparison between the single-knot running and interrupted technique. Urology 68:1284–1289

    Article  PubMed  Google Scholar 

  12. Andrews SM, Lewis JL (1994) Laparoscopic knot substitute: an assessment of techniques of securing sutures though the laparoscope. Endosc Surg Allied Technol 2:62–65

    PubMed  CAS  Google Scholar 

  13. Anderson KR, Clayman RV (2000) Laparoscopic lower urinary tract reconstruction. World J Urol 18:349–354

    Article  PubMed  CAS  Google Scholar 

  14. Ball AJ, Bordeau KP, Davis JW, Given RW, Lynch DF, Fabrizio MD (2005) Modified running vesicourethral anastomosis after robotically assisted laparoscopic radical prostatectomy: use of solitary Lapra-Ty to secure posterior approximation. Urology 66:16–18

    Article  PubMed  Google Scholar 

  15. Shichiri Y, Kanno T, Oida T, Kanamaru H (2006) Facilitating the technique of laparoscopic running urethrovesical anastomosis using Lapra-ty absorbable suture clips. Int J Urol 13:192–194

    Article  PubMed  Google Scholar 

  16. Guillonneau B, Rozet F, Cathelineau X, Lay F, Barret E, Doublet JD, Baumert H, Vallancien G (2002) Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol 167:51–56

    Article  PubMed  Google Scholar 

  17. Finley DS, Perer E, Eichel L, Clayman RV (2005) Ureteral pseudodiverticulum associated with absorbable suture clips after laparoscopic pyeloplasty: case report. J Endourol 19:726–729

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Takahiro Yasui, Yasunori Itoh, Tetsuji Maruyama, Hidetoshi Akita, Yoshihiro Hashimoto, Keiichi Tozawa & Kenjiro Kohri

Authors
  1. Takahiro Yasui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yasunori Itoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tetsuji Maruyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hidetoshi Akita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshihiro Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Keiichi Tozawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kenjiro Kohri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takahiro Yasui.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yasui, T., Itoh, Y., Maruyama, T. et al. The single-knot method with Lapra-Ty clips is useful for training surgeons in vesicourethral anastomosis during laparoscopic radical prostatectomy. Int Urol Nephrol 41, 281–285 (2009). https://doi.org/10.1007/s11255-008-9414-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-008-9414-z

Keywords

Search

Navigation