V11-08 Omission of Hemostatic Suturing Is Safe for Single-Port Robotic Simple Prostatectomy—a Video Case Series

You have accessJournal of UrologyBPH/Male Voiding Dysfunction/Infection/Misc. Imaging (V11)1 May 2024V11-08 OMISSION OF HEMOSTATIC SUTURING IS SAFE FOR SINGLE-PORT ROBOTIC SIMPLE PROSTATECTOMY—A VIDEO CASE SERIES Gregory Kunkel, Chad Heflick, Connor Moriarty, and Igor Sorokin Gregory KunkelGregory Kunkel , Chad HeflickChad Heflick , Connor MoriartyConnor Moriarty , and Igor SorokinIgor Sorokin View All Author Informationhttps://doi.org/10.1097/01.JU.0001009368.07681.43.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The classically described open simple prostatectomy utilized suturing of the prostatic fossa for hemostasis and re-trigonalization, which was carried over into the modern robotic era. The purpose of our study was to challenge this accepted dogma by totally omitting suturing. METHODS: This was a retrospective single-center, single-surgeon study of 16 consecutive single-port robotic-assisted simple prostatectomy (SP-RASP) cases performed in an extraperitoneal, transvesical fashion. Hemostasis was achieved either with cautery only or with suturing and re-trigonalization. Perioperative, postoperative, and functional outcomes were compared between groups. RESULTS: Of 16 cases, 15 were successfully completed robotically. One case required conversion to open and thus was excluded from analysis. Overall, 8 cases were performed utilizing suturing and 7 cases were performed with cautery only. Age, ASA score, Pre-op IPSS, and prostate size were not significantly different between the 2 groups. BMI was the only statistically significant variable between groups (26.16 suturing group vs. 30.76 cautery group, p=0.007). In perioperative outcomes, there were no significant differences in OR time, EBL, transfusion rate, change in hematocrit, size of foley catheter balloon, and hospital length of stay. In postoperative outcomes, there were no significant differences in change in IPSS, specimen weight, change in PSA, post-op PVR, post-op IPSS, post-op QOL, and length of follow up. There were 2 men in each group who required anticholinergics post-operatively, however all stopped within 1 month. CONCLUSIONS: In this retrospective study, omission of suturing was completely safe for SP-RASP. While the sample size is small, further study is needed to challenge the accepted dogma of hemostatic suturing and re-trigonalization after simple prostatectomy. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e913 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gregory Kunkel More articles by this author Chad Heflick More articles by this author Connor Moriarty More articles by this author Igor Sorokin More articles by this author Expand All Advertisement PDF downloadLoading ...