Comparison between a novel knotless technique and the conventional single knot technique of laparoscopic radical prostatectomy by novice laparoscopists

• Published in: Journal of international medical research Vol. 46; no. 11; pp. 4472 - 4479
• Main Authors: Ye, Jianfei, Lu, Jian, Wang, Guoliang, Ma, Lulin
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.11.2018; Sage Publications Ltd; SAGE Publishing
• Subjects: Aged; Aged, 80 and over; Cancer surgery; Clinical Research Reports; Humans; Laparoscopy; Male; Middle Aged; Postoperative Care; Prostate; Prostate cancer; Prostatectomy - methods; Suture Techniques; Treatment Outcome; Urological surgery; Knotless technique; laparoscopic radical prostatectomy; single knot technique; dorsal vein complex; minimal invasiveness; urethrovesical anastomosis
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060518773017

Objectives This study aimed to investigate a novel knotless technique for novice laparoscopists in traditional laparoscopic radical prostatectomy. Methods We studied 68 patients who had a novel technique performed in laparoscopic radical prostatectomy (knotless group) and 89 who had the conventional single knot technique (single knot group). The operations were all performed by novice laparoscopists with experience of fewer than 100 cases of laparoscopic radical prostatectomy. Knotless suture of the dorsal vein complex was conducted using a barbed self-retaining suture with three bites at the same location. The knotless urethrovesical anastomosis technique was conducted using a unidirectional single running fashion with a barbed self-retaining suture. Results There were no significant differences in the estimated blood loss, complication rate, postoperative hospital stay, anastomotic leakage rate, continence at 6 months after surgery, and positive margin rate between the two groups. The mean anastomotic time (24.9 vs. 44.2 min), operative time (168.1 vs. 201.8 min), and duration of catheter placement (12.8 vs. 19.8 days) were shorter in the knotless group than in the single-knot group. Conclusions The knotless technique of laparoscopic radical prostatectomy is a safe and effective procedure.