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18 recordsLinked to original sources
PubMed2026

Sutureless versus renorrhaphy in robot-assisted off-clamp partial nephrectomy: a systematic review and meta-analysis.

BACKGROUND: The necessity of routine parenchymal renorrhaphy during off-clamp robot-assisted partial nephrectomy (RAPN) remains uncertain. This study aimed to compare perioperative, functional, safety, and oncological outcomes between sutureless and conventional renorrhaphy. METHODS: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. Comparative studies evaluating sutureless versus conventional renorrhaphy during purely off-clamp RAPN were included. Trifecta achievement was the primary outcome. Random-effects models were used for pooled analyses, with subgroup analysis according to study design. RESULTS: Four studies involving 787 patients, including one randomized controlled trial (RCT) and three propensity score-matched (PSM) studies, were included. The overall pooled estimate showed no statistically significant difference in Trifecta achievement (RR 1.17, 95% CI 0.97-1.41), with substantial heterogeneity (I² = 86.5%). The PSM studies favored the sutureless approach (RR 1.26, 95% CI 1.05-1.52), whereas the RCT yielded an RR of 0.97 (95% CI 0.92-1.04) and met the prespecified noninferiority criterion without demonstrating superiority. The sutureless approach was associated with a smaller perioperative eGFR decline (MD - 3.89, 95% CI - 6.16 to - 1.62), while no significant difference was observed in eGFR at 3 months. No statistically significant differences were identified in major complications, blood transfusion, or positive surgical margins; urinary and vascular complications were sparsely reported. CONCLUSIONS: In selected patients undergoing purely off-clamp RAPN, randomized evidence supports the noninferiority of a strategy that omits routine parenchymal renorrhaphy while permitting clinically necessary selective repair, but does not demonstrate superiority. Favorable estimates from PSM studies remain vulnerable to intraoperative treatment-selection bias. Current evidence is insufficient to determine whether omission of renorrhaphy affects urinary complications, long-term renal function, or oncological outcomes. REGISTRATION: This systematic review was registered prospectively in PROSPERO (CRD420261435995).

Humans↗
PubMed1992

Sterile endophthalmitis after sutureless cataract surgery.

BACKGROUND: Sutureless cataract surgery has recently increased in popularity because of the rapid visual rehabilitation and the inherent reduction of surgically induced astigmatism. METHODS: This procedure is dependent on a lamellar, multiplaned incision. As with new surgical techniques, associated complications become evident with time. Recently, there have been several cases of infectious endophthalmitis after this procedure. The authors report on nine cases of sterile endophthalmitis. In all nine cases, surgery was performed with refrigerated balanced salt solution (BSS) and 100 mg of cefazolin and/or 20 mg of methylprednisolone sodium succinate, given subconjunctivally, at its completion. RESULTS: All nine cases occurred in a period of time during which 68 cases were performed using refrigerated BSS for irrigation. These nine cases came from two different surgeons using basically the same surgical technique. After the investigation of these complications, the refrigerated BSS was discontinued, and there have been no episodes of sterile endophthalmitis in the last 650 cases. CONCLUSION: It appears that refrigerated BSS should be avoided if periocular injections are going to be used. It may be that the cold BSS fails to allow sufficient tissue swelling to seal the surgical incision, allowing for subconjunctival injections to seep into the wound, and leading to a sterile endophthalmitis.

Aged↗
PubMedDate not supplied

No-suture aphakic epikeratoplasty.

BACKGROUND: Use of sutures with aphakic epikeratoplasty is time-consuming during surgery and can create significant hazards for the patient. Thus, a surgical technique for aphakic epikeratoplasty without sutures was developed. METHODS: The conventional procedure was modified to use an oversized lenticule tucked evenly in an expanded lamellar pocket with no anchoring sutures. The technique was performed on one eye of 27 consecutive patients over a 9-month period. RESULTS: After a mean follow up of 14 months, results showed refractive and visual parameters comparable to a sutured technique. A 100% success rate at surgery was obtained using the oversized 9-millimeter lenticule. Five eyes (19.2%) developed a partial lenticule edge dislocation postoperatively. Three of the edge dislocations were reposited at the slit lamp without suturing. One lenticule, manufactured undersize, required primary suturing, leaving 24 of 26 (92.3%) patients healed without sutures. Postoperative spectacle-corrected acuity for the group either improved by one or more Snellen lines or remained unchanged. Two patients had reduced vision: one due to unrelated retinal changes and one due to vernal catarhh resulting in a persistent epithelial defect with subsequent epithelial haze. CONCLUSIONS: A sutureless technique can accomplish visual rehabilitation comparable to the conventional procedure. While the technique is not without complication, significant benefits to the patient include reduced morbidity, eliminating hazards of postoperative suture management, and a simplified surgical procedure.

Adolescent↗
PubMedDate not supplied

[The results of the surgical treatment of femoral hernias by suture-free alloplasty].

A new method of plasty of hernial hilus for femoral hernias is proposed which consists in sutureless fixation of allotransplants made of silicone having the form of a mushroom-shaped element. The transplant gives good and reliable closure of the hernial hilus without changing the interrelation of tissues. The duration of the operative procedure becomes considerably shorter, any injuries of large vessels were excluded as well as the development of ligature fistulas, suppuration of the wounds and recurrent hernias. An analysis of nearest and long-term results of treatment of 68 patients operated upon shows high efficiency of the method proposed.

Aged↗
PubMed1977

[Fibrin adhesion (orientating animal experiments) (author's transl)].

For some time fibrin adhesion is successfully used instead of sutures in different branches of surgery. We tested in animal experiments whether this method can be used for a sutureless closure of perforating corneal and corneoscleral wounds. Our results up to now do not show us any such possibility.

Animals↗
PubMed1992

Sutureless anastomosis of blood vessels using cyanoacrylate adhesives.

On the assumption that the remaining suture threads of the anastomotic line play an important role in the progression of anastomotic neointimal hyperplasia, we performed an experimental study on the sutureless anastomosis of blood vessels. An expanded polytetrafluoroethylene graft, 5 mm in diameter and 2 cm in length, was implanted on the abdominal aorta of mongrel adult using one of three methods of anastomosis, namely; a continuous suture, a stay suture, or sutureless anastomosis. Overall patency rates were 83.3 per cent, 91.7 per cent and 75.0 per cent respectively. The thickness of the pannus in the distal anastomotic line after 12 months was 107 microns in one graft in the continuous suture group, 106 microns and 222 microns in 2 grafts each in the stay suture group, and 41 microns and 117 microns in 2 grafts each in the sutureless group. Because there were cases of patency even after 12 months with a very small pannus thickness, sutureless anastomosis is considered to be a useful method of preventing anastomotic neointimal hyperplasia.

Anastomosis, Surgical↗
PubMed1992

Sutureless laparoscopic rectopexy for procidentia. Technique and implications.

Procedures for treating rectal prolapse may constitute some of the best applications for colorectal laparoscopic techniques. Although the condition is benign, rectal prolapse is often debilitating and frequently progressive in terms of functional limitations. Moreover, many patients are elderly, medically unfit, or both. A technique that afforded relief of prolapse and of incontinence by laparoscopic rectal sacropexy, performed without sutures, using a newly designed laparoscopic sacral tacker and laparoscopic staples, is described. Indications, contraindications, technical details, and surgical implications are discussed. Laparoscopic pelvic suspension procedures are presented as realistic and appropriate objectives for colon and rectal surgeons.

Colorectal Surgery↗
PubMed1991

Sutureless vascular anastomosis with biocompatible heat-shrink tubing.

We have tested a new method of vascular repair using biocompatible, low-temperature, heat-shrinkable tubing on canine carotid arteries. All of 16 canine carotid arteries were patent immediately after the anastomosis. None of the anastomoses leaked after the clamps were released. Average time from severing the vessel to releasing the clamps was 12 minutes. At 2 weeks, nine of 12 vessels were patent; the three failures were attributed to infection of a seroma that occurred in all of the dogs' necks. Histologic evaluation of the uninfected cases showed no inflammatory exudate around the prosthesis. Macroscopic and electron microscopic examination confirmed healing of the endothelium across the anastomoses. Sutureless vascular anastomosis with biocompatible heat-shrink tubing is a potential new modality for the acute repair of severed vessels.

Anastomosis, Surgical↗
PubMed1992

Sutureless repair of inguinal hernia.

Sutureless repair is successful for all but the largest of indirect inguinal hernias. After reduction of the peritoneal sac, the presenting indirect component of the hernia is immediately resolved by placement of a polypropylene mesh through the internal ring. The posterior wall is reinforced with a second swatch of Prolene mesh to prevent herniation, which often results from future degenerative changes. Both swatches of mesh are held in place in separate tissue planes by the body's internal hydrostatic forces. Being sutureless, no tension is placed on any layer; there is no damage to tissues from an errant suturing technique. This procedure has been used in 412 of the 1,091 inguinal hernia repairs over the past 36 months.

Adolescent↗
PubMed1976

Left subcostal insertion of the sutureless myocardial electrode.

This report describes the use of a left subcostal extrapleural supradiaphragmatic approach to the heart for myocardial sutureless electrode insertion. Electrode insertion by this approach has consistently produced low electrode thresholds, and the ability to insert electrodes into the left ventricle or septal area of the right ventricle is considered an advantage. This technique has now been used in 52 patients. Postoperative morbidity and complications have been minimal. The procedure appears to be well tolerated in the elderly, poor-risk patient and has been a useful technique for revision of failed pacemaker systems. We believe this procedure reduces the indications for permanent transvenous pacing.

Adult↗
PubMed1976

A new sutureless technique for skin closure.

A sutureless wound-closure device was used in 150 patients. The average time spent to effect skin closure was reduced; removal was easy; skin apposition was satisfactory; and patient response was favorable. Sutureless tape closures eliminate the disadvantages of invasive skin closures. The device described provides secure tape adhesion to the skin and does not cover the wound. It can be easily applied, adjusted, and removed, in addition to serving as a protective splint to the healing wound. This method can reduce operative time of skin closure with highly satisfactory cosmetic results.

Adolescent↗
PubMed1992

Partial pancreaticoduodenectomy (Whipple procedure) for pancreatic malignancy: occlusion of a non-anastomosed pancreatic stump with fibrin sealant.

Following partial pancreaticoduodenectomy for periampullary and pancreatic cancer, the complication and mortality rates are particularly high. Various approaches have aimed at improving the postoperative result, with less than complete success. The discouraging results of others, and our own dissatisfaction, led us to evaluate an atraumatic, sutureless method for management of the residual gland. Following head resection, the remaining pancreas is occluded with a fibrin sealant (Tisseel c, Immuno AG, Vienna) via injection into the pancreatic duct, which is then ligated and left free in the peritoneal cavity. Among 44 patients treated with this method, there were no perioperative deaths. Three patients developed local complications (2 fistulae, 1 pancreatitis) due to technical errors that presumably resulted in incomplete occlusion. Evaluation of patients after two to three years indicates that the endocrine function of the pancreas has been largely conserved despite ductal occlusion.

Aged↗
PubMedDate not supplied

Some general principles of tissue crushing and regeneration during sutureless anastomosis of hollow organs of the alimentary tract.

Tissues of the hollow organs of the gastrointestinal tract are crushed in order to create an anastomosis. The processes taking place in the tissues have been inadequately studied. A model of the tissue crushing process is suggested and the results of theory and experiments are compared. Dependence of the rejection time of the crushing influence on the crushing force was demonstrated experimentally. The relationship obtained can be explained on the grounds that migration of cell destruction products from the zone of crushing to the zones of healing stimulates adequate cellular immunologic processes. The views developed in this paper may prove useful for the elaboration of new surgical techniques.

Animals↗
PubMed1991

Sutureless hemisplenectomy.

Splenic salvage following blunt injury can fail when parenchymal bleeding is uncontrollable. To define the usefulness of an argon beam coagulator for hemostasis, we used the instrument in a laboratory trial of partial splenic resection. New Zealand white rabbits, weighing 4 to 5 kg, had sharp excision of the lower half of the spleen. No sutures were used to control hemorrhage from the cut splenic surface or the hilar vessels. Hemostasis was achieved with 2 to 4 seconds of electrocoagulation delivered by a beam of argon gas. All animals survived the procedure and were in good health when killed between the fourth and sixth week following the procedure. At necropsy, the spleen was viable in all animals with no abscess or hematoma. Minimal adhesions from the treated splenic surface to the omentum were found. The scar at the cut surface was 1 mm in depth, and the histology of the remainder of the spleen was normal. In this simulated splenic injury model, argon beam coagulation was uniformly successful in achieving hemostasis. Minimal tissue destruction and lack of infection were noted. The argon beam coagulator may be useful in patients with severe splenic injuries and other situations requiring partial splenectomy.

Animals↗
PubMed1992

Experimental carcinogenesis at sutured and sutureless colonic anastomoses.

This study explores the role of sutures and the healing colonic wound in experimental carcinogenesis. One hundred sixty rats underwent surgery with colotomy and repair using silk, steel, or Vicryl (Ethicon, Somerville, NJ) sutures or a sutureless technique. Forty rats had a sham procedure. All animals received azoxymethane for 12 weeks at a dose of 10 mg/kg/week. Half the rats commenced carcinogen before surgery, and half commenced it eight weeks after surgery. Animals with anastomotic tumors were found in 46 percent of the sham group (P less than 0.05 cf. sutured), 41 percent of the sutureless group (P less than 0.02 cf. sutured), and 68 percent of the sutured group. The corresponding figures for anastomotic carcinoma were 9 percent (P less than 0.001 cf. sutured), 22 percent, and 38 percent. No significant differences in tumor yield were noted among the different sutures. However, several differences were noted between the two carcinogen models. In those animals that received surgery first, there was a higher incidence of anastomotic tumors (P less than 0.002) and cancers (P less than 0.0001) in the sutured and sutureless groups, and those tumors that occurred in the sutured group were considerably larger than in those that had carcinogen first (15.9 mm cf. 4.9 mm; P less than 0.0001). Overall, all sutures seem to enhance anastomotic tumor formation, and we would suggest that a sutureless anastomosis may diminish this risk.

Anastomosis, Surgical↗