Use of a barbed suture for the urethro-vesical anastomosis during the learning curve of the endoscopic extraperitoneal radical prostatectomy.

OBJECTIVES: The performance of the urethrovesical anastomosis is one of the most difficult steps in urologic laparoscopy. Many different techniques have been developed to improve this step and, recently, new sutures such as the V-loc (R) barbed system have been created. In the present study we analyze the usefulness of this suture for diminishing the time employed for the anastomosis suture during the learning curve of laparoscopic radical prostatectomy.
METHOD: We performed a prospective comparative study between two groups. The first group included the first 50 cases of a novel surgeon using this barbed suture, and we compared these procedures with 50 consecutives cases of an experienced surgeon. We compared preoperative parameters, surgical and suturing times, as well as drain and catheter duration, and hospital stay.
RESULTS: We did not find statistically significant differences in any pre or postoperative parameters between both groups. Although surgical time was lower in the control group this difference was not statistically significant. The time used to perform the suture was lower in the study group, and we found significant differences between both groups. Neither drain nor bladder catheter times were different between groups.
CONCLUSIONS: In the absence of prospective randomized trials comparing barbed or not barbed running sutures, our study shows that the use of the V-loc® system improves the times needed for the urethrovesical anastomosis during the learning curve of laparoscopic radical prostatectomy.