Manual and mechanical sutures in bladder substitutions

Abstract

The increasing use of mechanical sutures in urological surgery has highlighted some particular problems about the behaviour of the intestinal wall around the mechanical anastomosis. The Authors report on 160 bladder substitutions performed between April 1990 and April 1994. Histological and biological evaluation of intestinal repair and epithelisation show how the newly formed mucosa covers the steel stitches, isolating them from contact with the urine, so their potency to favour stone growth is very low. The particular shape and arrangement of stitches done with the GIA stapling device ensure a stronger and better vascularised suture than one done manually. In conclusion, the use of stapling devices in urological surgery offers the advantages of time saving and accuracy and safety of the sutures.