A new technique for laparoscopic vesicourethral anastomosis: preliminary report.

OBJECTIVES

To introduce a new and easy technique to perform laparoscopic vesicourethral anastomosis with a single-suture, single-knot, running procedure.

METHODS

We have performed 350 laparoscopic radical prostatectomies. In a prospective study, we evaluated a new anastomosis technique in 50 consecutive cases. A multiple knot is prepared at 4 cm from the end of a suture. Then the running suture is started at the bladder neck at 4 o'clock. The posterior plate is maintained open for the first throws, and the suture is pulled only after the third passage at the bladder neck. Then the running suture is completed clockwise and finally tied to the 4-cm tail.

RESULTS

Use of this technique in 50 patients was compared with use of a double running suture in 50 other patients. The 2 groups were comparable. The new procedure was related to a decreased anastomotic time, without complications, with no leak at catheter removal at postoperative day 5 or 6.

CONCLUSIONS

The experience with this original anastomosis is still preliminary, but the results are very promising, and we would like to propose it to laparoscopic urologists.