Dataset Information

Innovative suture technique for robotic hepaticojejunostomy: double-layer interrupted sutures.

ABSTRACT:

Purpose

Biliary reconstruction remains a technically demanding and complicated procedure in minimally invasive hepatopancreatobiliary surgeries. No optimal hepaticojejunostomy (HJ) technique has been demonstrated to be superior for preventing biliary complications. This study aimed to investigate the feasibility of our unique technique of posterior double-layer interrupted sutures in robotic HJ.

Methods

We performed a retrospective analysis of a prospectively collected database. Forty-two patients who underwent robotic pancreatoduodenectomy using this technique between September 2020 and November 2022 at our center were reviewed. In the posterior double-layer interrupted technique, sutures were placed to bite the bile duct, posterior seromuscular layer of the jejunum, and full thickness of the jejunum.

Results

The median operative time was 410 (interquartile range [IQR], 388-478) min, and the median HJ time was 30 (IQR, 28-39) min. The median bile duct diameter was 7 (IQR, 6-10) mm. Of the 42 patients, one patient (2.4%) had grade B bile leakage. During the median follow-up of 12.6 months, one patient (2.4%) with bile leakage developed anastomotic stenosis. Perioperative mortality was not observed. A surgical video showing the posterior double-layer interrupted sutures in the robotic HJ is included.

Conclusions

Posterior double-layer interrupted sutures in robotic HJ provided a simple and feasible method for biliary reconstruction with a low risk of biliary complications.

SUBMITTER: Takagi K

PROVIDER: S-EPMC10356881 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Innovative suture technique for robotic hepaticojejunostomy: double-layer interrupted sutures.

Takagi Kosei K Umeda Yuzo Y Yoshida Ryuichi R Fuji Tomokazu T Yasui Kazuya K Yagi Takahito T Fujiwara Toshiyoshi T

Langenbeck's archives of surgery 20230720 1

<h4>Purpose</h4>Biliary reconstruction remains a technically demanding and complicated procedure in minimally invasive hepatopancreatobiliary surgeries. No optimal hepaticojejunostomy (HJ) technique has been demonstrated to be superior for preventing biliary complications. This study aimed to investigate the feasibility of our unique technique of posterior double-layer interrupted sutures in robotic HJ.<h4>Methods</h4>We performed a retrospective analysis of a prospectively collected database. F ...[more]

PMID: 37468703

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Project description:BackgroundCesarean scar defects can lead to long-term complications, such as cesarean scar disorders, cesarean scar pregnancy, and the risk of uterine scar dehiscence and rupture in subsequent pregnancy. However, the optimal closure technique to prevent the development of cesarean scar defects (CSD) remains unclear. Therefore, this study aimed to explore whether two-layer interrupted versus two-layer continuous sutures could prevent the formation of CSD.MethodsA randomized controlled trial was conducted in a single university hospital in Japan. We recruited pregnant women with ≥ 20 primary or previous cesarean sections. Participants were randomly assigned to either a two-layer interrupted or a two-layer continuous suture group. Residual myometrial thickness (RMT) and the depth of CSD were measured using sonohysterography, 6-8 months post-cesarean section. In addition, the rate of severe CSD, defined as a loss of over 50% of the myometrium, was examined.ResultsOf the 220 study participants, 43 dropped out; 89 in the interrupted group and 88 in the continuous group underwent sonohysterography. No significant difference in RMT was observed in the interrupted and continuous groups (median 8.1 [interquartile range, 6.2-9.9] mm and 7.9 [4.6-10.3] mm, respectively). However, the incidence of severe CSD in the interrupted group was significantly lower than that in the continuous group (2% versus 22%, p < 0.0001). Multivariate logistic regression analysis revealed that the factors contributing to developing severe CSD were interrupted suture (odds ratio [OR]: 0.04, 95% confidence interval [95%CI]: 0.006-0.281, p = 0.0011), the difference in myometrial thickness between the fundal and cervical sides at the center of the uterine wound before suturing (OR: 1.65, 95%CI: 1.144-2.367, p = 0.0072), and retroversion of the uterus at 6-8 months after cesarean section (OR: 3.42, 95%CI: 1.074-10.946, p = 0.0374).ConclusionThis study suggested that two-layer interrupted sutures are superior to two-layer continuous sutures in preventing the development of severe CSD.Trial registrationClinical trial identification number: University Hospital Medical Information Network registration code, UMIN000040601. URL of the registration site: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046334 .

Dataset Information

Innovative suture technique for robotic hepaticojejunostomy: double-layer interrupted sutures.

Purpose

Methods

Results

Conclusions

Publications

Innovative suture technique for robotic hepaticojejunostomy: double-layer interrupted sutures.

Similar Datasets

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