ABSTRACT
【Objective】 To investigate the efficacy of the adjustable "paper clip" techniques in the suture of dorsal vein complex (DVC) and retention of urethral function in robot-assisted laparoscopic radical prostatectomy (RALRP). 【Methods】 A total of 30 cases of prostate cancer treated with RALRP were enrolled, all of which used the adjustable "paper clip" techniques. During operation, the DVC was sewed with barbed suture, and then a reverse suture was made through two sides of the prostatic ligaments. A Hem-o-lock was used to fasten the suture, which would be flexible to control the degree of tightness for the ligature. Perioperative and follow-up data of urinary continence and symptoms were collected and analyzed. 【Results】 All operations were successful. The estimated blood loss was (123.3±80.7) mL, 53.6% patients recovered continence in 1 month, and the continence rate increased to 92.9% and 96.3% at month 3 and 6. 92.9 of patients had no risk of incontinence 3 months after surgery. 【Conclusion】 The adjustable "paper clip" techniques have advantages in reducing blood loss, maintaining clear surgical field, preserving urethral function, and improving urinary continence.
ABSTRACT
Objective To assess the efficacy of dorsal vein complex(DVC)ligation free in laparoscopic radical prostatectomy. Methods The data of 25 patients underwent laparoscopic radical prostatectomy that performed by the same surgeon in our hospital from January 2012 to January 2014 were retrospectively analyzed. Among them,14 cases underwent sutured DVC,11 cases received sutured DVC. Results All the operations were completed with laparoscope and without convert to open surgery. The mean operation time was 246±24.7 min and 236±26.1 min in DVC liga?tion and DVC ligation free,the blood loss was 337.5±120.2 mL and 322.2±104.9 mL in DVC ligation and DVC ligation free,the blood transfusion rate was 14.3%and 18.2%in DVC ligation and DVC ligation free ,the urinary incontinence rate of 6 months after operation was 21.4%and 9.1%in DVC ligation and DVC ligation free,no significant difference was found in the operation time,blood loss,blood transfusion rate and urinary in?continence rate among the two groups(P>0.05). Conclusion DVC ligation free is a safe and effective technique during laparoscopic radical prostatectomy and may simplify the operative procedure and without increase of the risk of bleeding ,which can be more conducive to the early re?covery of postoperative urinary control.
ABSTRACT
Objective To evaluate the use of bunching forceps during radical prostatectomy. Methods 14 cases of radical prostatectomy/cystectomy were performed with the use of bunching forceps to control bleeding from the dorsal vein complex. Results The procedure resulted in minimal bleeding from dorsal complex and was helpful in rhabdosphincter. Conclusions The bunching forceps is very valuable for controlling bleeding from dorsal vein complex and for preserving rhabdosphincter.