Vesicourethral anastomosis using V-Loc™ barbed suture during robot-assisted radical prostatectomy

In Europe, localized prostate cancer (PCa) is increasingly treated by robot-assisted radical prostatectomy. This minimally invasive procedure is technically evolving, with benefits to both the patient and surgeon. One of the final steps of the operation is the formation of a watertight vesicourethral anastomosis (VUA). A suboptimal anastomosis can lead to serious consequences, including acute urinary leak, ileus, prolonged hospitalization and catheterization, urethral stricture, and urinary incontinence. It is therefore highly desirable to develop a simple, reproducible and dependable technique for VUA formation. We report a VUA formation technique using a unidirectional barbed suture (3-0 V-LocTM 180 absorbable suture, Covidien, Dublin, Ireland).