Evolución y optimización con los avances en suturas y energía de procedimientos urológicos laparoscópicos en Puebla

Objective: To analyze the evolution of laparoscopic surgery and the influence of technical elements, such as the use of bipolar grasper and barbed suture in surgical success. Methodology: A retrospective review of medical files and surgical videos of laparoscopic procedures of a single surgeon was done. Descriptive statistics was performed in search of differences in surgical time and bleeding. Results: A total of 140 procedures were included, with 89.3% performed in private hospitals, mostly radical prostatectomy (42.8%), radical nephrectomy (33.5%), partial nephrectomy (5.7%), and others. The average surgical time was 130.2 minutes, with an average bleeding of 430cc, with only 4 severe complications (2.1%), and a low mortality rate of 0.7%. The conversion rate to open surgery was 1.4%. The hospital stay was in average 2.4 days. The implementation of bipolar grasper and barbed sutures diminished the surgical time and bleeding. Study limitations: Because this is a single surgeon's experience in time, with diverse surgical procedures, a multicentric comparative study should be undertaken to confirm the results. Originality: In Mexico, there are no studies that evaluate the use of technology in laparoscopic urologic surgery. Conclusions: This paper reports on the evolution of the surgeon's technique and experience, which have enabled an optimization in surgical times and postoperative outcomes associated to the use of the technology for dissection and the use of barbed sutures to improve results.