Comparison of Laparoscopic and Open Cystopexy in a Cadaveric Canine Model.

Abstract

OBJECTIVE: To describe a technique for laparoscopic cystopexy using knotless barbed suture and to compare this technique with traditional cystopexy using standard suture in a cadaveric canine model. STUDY DESIGN: Cadaveric study. ANIMALS: Male canine cadavers (n = 12). METHODS: Cadavers were randomly assigned to 2 groups: laparoscopic (n = 6) and open (n = 6) cystopexy. Laparoscopic cystopexy was performed intracorporeally using barbed, glycomer 631 suture. Open cystopexy was performed using standard glycomer 631 suture. Pre- and postoperative positive contrast cystography was performed in all dogs. Cystopexy procedure time, length and adherence, as well as number of bladder mucosal suture penetrations were compared between groups. RESULTS: Mean ± SD cystopexy procedure time was 14.0 ± 3.0 minutes and 5.2 ± 0.5 minutes for the laparoscopic and open groups, respectively (P = .0007). Laparoscopic and open cystopexy lengths were 2.5 ± 0.4 and 2.4 ± 0.5 cm, respectively (P = .43). Partial suture pullout occurred in 1 dog in the laparoscopic group but subjective cystopexy adherence was adequate in all dogs. Bladder mucosal suture penetration occurred in 3 dogs in both groups (P = .86). Two of 6 cadavers with luminal suture penetration had minor contrast leakage on postoperative contrast cystography. Pre- and postoperative contrast cystography revealed appropriate bladder position in all cadavers. CONCLUSION: Laparoscopic cystopexy using knotless suture was comparable to an open cystopexy but was associated with a slightly longer procedure time and should be suitable for laparoscopic cystopexy in vivo.