Search

Background and Objectives: The multiple endoclip retraction technique (MERT) was developed based on our experience with suturing renal parenchyma in laparoscopic partial nephrectomy. In this study we prospectively evaluated the one-year results of cases treated by transperitoneal laparoscopic Burch with the MERT., Methods: The patients were evaluated with stress test, one-hour pad test, and were requested to complete the International Continence Society Incontinence Questionnaire short form (ICIQ-SF) in the postoperative period. The follow-up periods were postoperative 3, 6, and 12 months., Results: The primary outcome of this study was surgical success, defined as being cured of stress urinary incontinence (SUI) (no symptoms), experiencing improved symptoms of SUI in ICIQ-SF and negative stress test, and less than 2g urine leakage in a one-hour pad test.No statistically significant difference was found in terms of age, number of children, and body mass index (BMI) in patients according to the results of the 12 month postoperative stress test. We found statistically significant improvements at all control months in terms of stress test and pad weight. ICIQ-SF results showed a significant decrease at three months in patients who recovered after the operation. This rate has not changed in following control months. However, there was no statistical change in ICIQ-SF values in patients who did not recover after the operation., Conclusion: MERT seems to be one of the safe and effective modifications in the management of SUI with good one year outcomes when performed by suitably trained experienced surgeons., (© 2022 by SLS, Society of Laparoscopic & Robotic Surgeons.)

Background and Objectives: The search for the perfect suture is going on and has resulted in the introduction of many different suture types into the market. The purpose of this study is to investigate the holding strength (HS) of different sutures in the renal parenchyma in an experimental study on pig kidneys., Methods: The HS that caused sliding of the suture was investigated in 5 adult porcine kidneys with 7 suture variants. HS-caused tearing of the kidney was investigated with 3 suture types on 5 kidneys. The third investigation, performed on 5 porcine kidneys, was a comparison between 2-0 Vicryl sutures with a Hem-o-lok clip and 2-0 V-Loc sutures with 1 knot. The Friedman test was used to compare the groups. Post hoc analysis was performed with the Wilcoxon signed ranks test (Bonferroni corrected)., Results: For HS causing sliding of the suture, the mean HSs of the tested sutures were as follows: 2-0 Vicryl with 1 Hem-o-lok clip, 3.26 ± 0.55 N; 2-0 Vicryl with 2 Hem-o-lok clips, 4.1 ± 0.46 N; 2-0 V-Loc, 2.52 ± 0.63 N; 4-0 V-Loc, 1.62 ± 0.17 N; 0 Quill, 0.48 ± 0.16 N; 2-0 Vicryl with 1 Hem-o-lok clip (halfway), 3.62 ± 0.66 N; and 2-0 V-Loc (halfway), 1.02 ± 0.40 N. For HS causing tearing of the kidney, the mean value of 2-way 2-0 Vicryl (Hem-o-lok in the middle) was 13.28 ± 1.38 N, 2-0 2-way Vicryl (Hem-o-lok at the end) was 5.86 ± 0.75 N, and 2-way 2-0 V-Loc was 3.98 ± 1.60 N. For the third group, the difference between the 2 suture variants was not statistically significant., Conclusion: Our study revealed that 2-0 Vicryl (polyglactin 910) sutures with 2 Hem-o-lok clips had the maximum HS in renal parenchyma when compared with other sutures.