1394 TECHNICAL RAY OF HOPE IN THE CONTEXT OF MINIMALLY INVASIVE URINARY DIVERSION: SEWING WITH THE PROTOTYPE DEVICE ENDOSEW® - RESULTS OF AN INTRAOPERATIVE HUMAN PILOT SERIES

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics - Malignant Disease & Benign Disease II1 Apr 20121394 TECHNICAL RAY OF HOPE IN THE CONTEXT OF MINIMALLY INVASIVE URINARY DIVERSION: SEWING WITH THE PROTOTYPE DEVICE ENDOSEW® - RESULTS OF AN INTRAOPERATIVE HUMAN PILOT SERIES Beat Roth, Frederic D. Birkhaeuser, George N. Thalmann, and Pascal Zehnder Beat RothBeat Roth Bern, Switzerland More articles by this author , Frederic D. BirkhaeuserFrederic D. Birkhaeuser Bern, Switzerland More articles by this author , George N. ThalmannGeorge N. Thalmann Bern, Switzerland More articles by this author , and Pascal ZehnderPascal Zehnder Bern, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1843AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Minimally invasive cystectomy is rapidly developing. However, complete intracorporeal confection of the urinary diversion remains challenging. Therefore, stapler devices are widely used to facilitate the reconstructive part of the procedure despite the known risk of infections and stone formation. Our goal was to evaluate feasibility and safety of an absorbable running suture for ileal conduits using the prototype sewing device EndoSew®. METHODS Consecutive series of 10 patients scheduled for urinary diversion with an ileal conduit. In order to close the proximal end of the resected bowel segment an extracorporeal running suture (Vicryl 3-0) was performed with the use of the prototype device EndoSew®. Feasibility and time requirements of the procedure were analyzed as were the number of stitches and length of suture line. Water tightness of the suture line was assessed with methylene blue intraoperatively and with loopographies on postoperative day 7 and 14. Technical requirements and complications were recorded as were overall and intervention specific complications occurring within 30d following surgery. RESULTS A complete running suture with EndoSew® was feasible in all but 1 patient (90%). Median suturing time was 5.5min (range:3-10), median suture length was 4.5cm (range:2-5.5). In three patients, an additional single freehand stitch was needed at the beginning and/or the end of the suture line in order to anchor the running machine thread. In one patient, suturing with the device had to be abandoned due to a mechanical problem after 50% of the suturing distance. Finally, all conduits were watertight at any time. No suture related complications were observed. CONCLUSIONS We present the first consecutive series of patients undergoing urinary diversion with an ileal conduit using the sewing device prototype EndoSew®. The procedure per se is feasible and safe. All sutures were watertight. Therefore, EndoSew® has the potential to facilitate the intracorporeal confection of the urinary diversion. However, technical refinements are necessary. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e566 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Beat Roth Bern, Switzerland More articles by this author Frederic D. Birkhaeuser Bern, Switzerland More articles by this author George N. Thalmann Bern, Switzerland More articles by this author Pascal Zehnder Bern, Switzerland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...