Work

Use of barbed suture for continuous urethro-vesical anastomosis in open retropubic radical prostatectomy: A new and practical approach

Year: 2025

Type: article

Abstract: Due to the insufficient data, further studies are required to assess the efficacy and safety of barbed sutures in open retropubic radical prostatectomy (RRP). We aimed to describe a novel vesicourethral anastomosis technique using barbed sutures during open RRP. A 65-year-old male with locally advanced prostate cancer underwent open retropubic RP with lymphadenectomy. Two 30 cm 3–0 barbed sutures (V-Loc™) were tied from their loop ends for double-needle use. After placing sutures at the 6 o'clock bladder neck and urethral positions, a running suture was performed posteriorly (5 and 7 o'clock), laterally (3 and 9 o'clock), and anteriorly (1, 11, and 12 o'clock) with mucosa-to-mucosa approximation. The anastomosis was completed by tying the anterior sutures. A 16F Foley catheter was inserted, and leak testing was performed with 250 cc saline. Anastomosis was completed in 15 min. The drain was removed on postoperative day one, and the catheter on day ten. Barbed sutures employed for anastomosis in laparoscopic and robotic radical prostatectomies are also applicable in open surgery. This approach, particularly when utilized with the preservation of a lengthy urethra and the bladder neck, can enhance functional outcomes in open RRP. Further studies are needed. Barbed sutures offer a practical and efficient vesicourethral anastomosis in open RRP. • To date, continuous vesicourethral anastomosis in open radical retropubic prostatectomy has been performed using poliglecaprone suture material, which has demonstrated superior outcomes in terms of anastomotic leakage and early continence when compared to interrupted vesicourethral anastomosis techniques. • The application of barbed sutures for anastomosis in open radical retropubic prostatectomy has not been previously reported in the literature. • Our study demonstrates its technical definition and applicability. Barbed sutures offer a practical and efficient vesicourethral anastomosis in open retropubic retropubic prostatectomy.

Source: International Journal of Surgery Case Reports

DOI: 10.1016/j.ijscr.2025.112036

Authors: Akif Erbin, Metin Mod, Osman Can, Ahmet Eren Sagir, Halil Lutfi Canat

Institution: İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi

Language: English

Topic: Prostate Cancer Diagnosis and Treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090