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V-Loc urethro-intestinal anastomosis during robotic cystectomy with orthotopic urinary diversion. Can Urol Assoc J 2013 Nov-Dec;7(11-12):E663-6 PMID: 24282453 PMCID: PMC3840523

Pubmed ID

24282453

DOI

10.5489/cuaj.508

Abstract

INTRODUCTION: Robotic-assisted radical cystectomy (RARC) is an emerging minimally invasive alternative for the treatment of invasive bladder cancer. The V-loc (Covidien, Mansfield, MA) suture is a unidirectional barbed suture that provides even distribution of tension. We determined the rate of urinary leak at the urethro-intestinal anastomosis following orthotopic neobladder construction performed with V-loc suture.

METHODS: We retrospectively reviewed charts on all patients that underwent RARC with orthotopic neobladder urinary diversion performed with a V-loc suture from February 2010 to February 2012. The urethro-intestinal anastomosis was evaluated for urinary leak by cystogram at 3 to 4 weeks, postoperatively.

RESULTS: In total, 11 patients were available for analysis. The mean patient age was 57.2 years (range: 47-71). The average clinical follow-up was 8 months (range: 4-15). On surgical pathology, 8 (73%) patients had pT2 or less disease, 3 (27%) had pT3/T4 disease, and 1 (9%) had N+ disease. The mean intraoperative blood loss was 315 mL (range: 150-600) and the average operative time was 496 minutes (range: 485-519). No patient (0%) demonstrated a urinary leak at the urethro-intestinal anastomosis on postoperative cystogram. Eight patients (73%) were continent by 4 months, postoperatively.

CONCLUSIONS: Orthotopic neobladder urethro-intestinal anastomosis can be performed effectively and safely with V-loc suture with an acceptably low urinary leak rate.

Author List

Pham KN, Sack BS, O'Connor RC, Guralnick ML, Langenstroer P, See WA, Jacobsohn K

Authors

Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Kenneth Jacobsohn MD Associate Professor in the Urologic Surgery department at Medical College of Wisconsin
Peter Langenstroer MD Professor in the Urologic Surgery department at Medical College of Wisconsin
Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin
William A. See MD Chair, Professor in the Urologic Surgery department at Medical College of Wisconsin




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