1390 PROSPECTIVE, RANDOMIZED USE OF THE VLOC VESICOURETHRAL ANASTAMOSIS DURING ROBOT ASSISTED RADICAL PROSTATECTOMY: LONG-TERM FOLLOWUP
Bibliographic record
Abstract
You have accessJournal of UrologyTechnology & Instruments: Robotics - Malignant Disease & Benign Disease II1 Apr 20121390 PROSPECTIVE, RANDOMIZED USE OF THE VLOC VESICOURETHRAL ANASTAMOSIS DURING ROBOT ASSISTED RADICAL PROSTATECTOMY: LONG-TERM FOLLOWUP Kevin Zorn, Quoc-Dien Trinh, Dan Liberman, and Assaad ElHakim Kevin ZornKevin Zorn Montreal, Canada More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh Montreal, Canada More articles by this author , Dan LibermanDan Liberman Montreal, Canada More articles by this author , and Assaad ElHakimAssaad ElHakim Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1839AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Robotic vesicourethral anastomosis (VUA) using the Van Velthoven technique has significantly improved urinary reconstruction during RARP. Recent series suggest off-label use of barbed polyglyconate suture may facilitate VUA, however the long-term risk for stricture formation and impact on urinary continence is unknown. Compared to standard monofilament posterior reconstruction (PR) and VUA technique, we sought to evaluate the effectiveness of VLOC for urinary reconstruction with minimum 1 year followup. METHODS A prospective,randomized study was conducted in 120 consecutive RARP cases by a single-surgeon. Assurance of watertight closure was ensured with 300mL intraoperatively. Time to complete the suture setup, anastomosis time and need to adjust suture tension were recorded. Suture related complications, validated-questionnaire continence and a cost analysis were also analyzed. RESULTS Compared to our conventional reconstruction technique, there was a significant reduction in mean reconstruction time (14.1 vs 22.2 min; p < 0.01). Need to readjust suture tension or place additional LapraTy clips to establish a watertight closure was observed in 13 (22%) vs 5 (8%) of cases (p = 0.05). A cost reduction was also noted favouring the interlocked VLOC technique (48.05$ vs 70.25$CAN). Time to foley removal was comparable between groups(4.1 vs 4.2 days, p = 0.87). Need for catheter replacement was similar between groups (both 5%). With a mean followup of 18.2 months, no delayed clinical anastomotic leaks or bladder neck contractures were observed in either group. Padfree continence outcomes at 1 (64% vs 69%, p = 0.60), 3 (76% vs 81%, p = 0.54), 6 months (88% vs 92%, p = 0.67) and 12 months (90% vs 92%; p = 0.57), were also comparable. CONCLUSIONS Compared to standard monofilament suture, use of VLOC suture appears to provide a safe, more efficient and cost effective urinary reconstruction during RARP. Use of the interlocked-VLOC suture technique prevents slippage, precluding the need for assistance, knot tying, and constant reassessing of anastomosis integrity. More important, to the best of our knowledge, this is the longest followup with such soft-tissue suture material for urinary reconstruction. Despite initial concern for increased inflammation from delayed material absorption and suture barbs, no adverse outcomes are observed in long-term assessment. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e564 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Zorn Montreal, Canada More articles by this author Quoc-Dien Trinh Montreal, Canada More articles by this author Dan Liberman Montreal, Canada More articles by this author Assaad ElHakim Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".