The following is a summary of “Impact of Inner Layer Renorrhaphy Suture on Renal Artery Pseudoaneurysm Formation Following Robotic-assisted Partial Nephrectomy,” published in the December 2023 issue of Urology by Geldmaker, et al.

For a study, researchers sought to assess the impact of resection base inner layer renorrhaphy suture type on the renal artery pseudoaneurysm (RAP) rate following robotic-assisted partial nephrectomy (RAPN).

A retrospective review of 563 consecutive RAPNs performed by a single surgeon was conducted. Patients were categorized into three groups based on the type of base suture used: No base suture, monofilament barbed suture (2-0 V-Loc 180 absorbable suture, Medtronic, Minneapolis, MN), polyglactin 910 (2-0 Vicryl coated suture, Ethicon Inc, Cincinnati, OH). A secondary analysis compared suturing (Vicryl and V-Loc) versus no base sutures. All patients underwent outer cortical renorrhaphy with 0-Vicryl suture using the standard sliding clip technique.

Among the patients, 110 (19.5%) had V-Loc suturing, 255 (45.3%) had Vicryl suturing, and 198 (35.2%) had no base sutures. The median age of the patients was 62.8 years (interquartile range: 53.5-69.7), and the median RENAL score was 8 (6-9). The median mass size from preoperative imaging was 3.0 cm (2.5-4.0) for V-Loc, 3.3 cm (2.5-4.2) for Vicryl, and 2.0 cm (1.8-3.0) for no base suture (P < .001). Overall, 21 patients (3.7%) developed symptomatic postoperative RAP. The rate of RAP was 3.6% (4/110) for V-Loc, 3.9% (10/255) for 2-0 Vicryl, and 3.5% (7/198) for no base suture (P = 1.00). Similarly, the rate of RAP was 3.5% (7/198) for no base suture and 3.8% (14/365) for base suture (P = 1.00).

The utilization of base sutures and the type of base sutures used during RAPN did not predict the development of postoperative RAP.

Reference: goldjournal.net/article/S0090-4295(23)00728-8/abstract