1410 NOVEL USE OF THE CAPIO URETHRAL ANASTOMOTIC SUTURING DEVICE: A 50 CASE ASSESSMENT

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics: Benign & Malignant Disease (II)1 Apr 20131410 NOVEL USE OF THE CAPIO URETHRAL ANASTOMOTIC SUTURING DEVICE: A 50 CASE ASSESSMENT Elleson A. Schurtz, Jhanelle E. Markes, Mark R. Newton, and James A. Brown Elleson A. SchurtzElleson A. Schurtz Iowa City, IA More articles by this author , Jhanelle E. MarkesJhanelle E. Markes Iowa City, IA More articles by this author , Mark R. NewtonMark R. Newton Iowa City, IA More articles by this author , and James A. BrownJames A. Brown Iowa City, IA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2764AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Reported advantages of robot-assisted laparoscopic prostatectomy (RALP) over open radical retropubic prostatectomy (RRP) include less blood loss and a lower bladder neck contracture (BNC) rate. A recent modification to the RRP is the utilization of the Capio suture capture device for placement of urethrovesical anastomotic sutures. This device eliminates the need to place freehand sutures and increases control and precise placement of sutures. We hypothesized that use of the Capio device would reduce RRP BNC rates. We examined a 50-case, single-surgeon, single-institution sequential series for the incidence of BNC using the Capio device for urethrovesical anastomosis in RRP and compared it to published rates for RRP and RALP. METHODS A retrospective chart review was performed evaluating a series of 50 RRP utilizing the Capio device between February 2010 and May 2012. Variables examined included patient demographics, pathology, and postoperative complications. Postoperative BNC rates were compared to previously published BNC rates in RRP and RALP performed without the Capio device. RESULTS In all 50 cases, a resident physician surgeon used the Capio device and performed the majority of the anastomoses. The mean follow-up was 13.1 months. Forty-seven patients (94%) had follow-up data available for longer than 90 days postop. No patients were diagnosed with BNC within 90 days. Two patients (4%) subsequently developed BNC requiring treatment. One patient had a clinically insignificant BNC that was diagnosed 18 months postop due to inability to pass a Foley catheter when hospitalized for sepsis. The second patient was diagnosed 8 months postop after complaints of weak stream and frequency. An overall 4% BNC rate, and a clinically symptomatic 2% rate, was observed in a 50 sequential case series using the Capio device. This rate was on the lower end of published RRP BNC rates of 2-19%. It and was near the published RALP BNC rates of 0-3%. Many of these RALP series included procedures in which a faculty surgeon performed the anastomotic procedure. CONCLUSIONS Control and precision of the Capio device in creation of the anastomosis, even in a training situation, allows for BNC rates similar to those reported after a RALP continuous anastomosis, but larger studies with longer follow-up are needed to fully evaluate the efficacy of the Capio device. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e577-e578 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elleson A. Schurtz Iowa City, IA More articles by this author Jhanelle E. Markes Iowa City, IA More articles by this author Mark R. Newton Iowa City, IA More articles by this author James A. Brown Iowa City, IA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...