Editorial Comment

Abstract

Randomized controlled trials (RCTs) demonstrating strong evidence for surgical interventions are rare within urology. The authors of this report are to be congratulated on seeking to provide the best level of evidence for a new technology very early in its introduction. 1 Centre for Evidence Based MedicineCEBM > EBM Tools > Finding the Evidence > Levels of Evidence. http://www.cebm.net/index.aspx?o=1025 Google Scholar Recent urologic interest for the use of barbed sutures has been intense, predominantly for urethrovesical anastomosis (UVA) during robotic radical prostatectomy and during rennorhaphy within robotic partial nephrectomy. This is illustrated by the large number of abstracts on the subject at this year's major urologic meetings. Anastomosis During Robot-assisted Radical Prostatectomy: Randomized Controlled Trial Comparing Barbed and Standard Monofilament SutureUrologyVol. 78Issue 3PreviewTo compare perioperative and functional outcomes after urethrovesical anastomosis (UVA) with barbed polyglyconate and monofilament poliglecaprone in robot-assisted radical prostatectomy (RARP). Barbed polyglyconate suture was first used for the UVA during RARP beginning in January 2010; safety and feasibility were previously demonstrated in 51 patients. Full-Text PDF ReplyUrologyVol. 78Issue 3PreviewWe are thankful for the editorial comments and support many of the cautions raised in their critique. Ultimately, suture choice should be made according to surgeon preference and comfort; it is, after all, simply a tool. Although it is possible that barbed suture may be best used by “those who have already reached competence at UVA,” it would seem counterproductive for academic institutions to train robotic surgeons to use monofilament suture, which, in our opinion, is an inferior tool for the job of UVA. Full-Text PDF