| Temporary segmental renal artery occlusion using reverse phase polymer for bloodless robotic partial nephrectomy. | |
| | |
MedLine Citation:
|
PMID: 19683769 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: Renal vascular clamping with ensuing warm ischemia is typically needed during robotic or laparoscopic partial nephrectomy. We developed a technique for angiographic delivery of the novel intra-arterial reverse thermoplastic polymer LeGoo-XL that allows temporary selective vascular occlusion with normal perfusion of the remaining kidney. MATERIALS AND METHODS: Eight pigs underwent a total of 16 selective angiographic occlusions of the lower pole segmental artery using gel polymer. The technical feasibility of 2 hemostatic techniques, perfusion hemostasis and local plug formation, was assessed in 4 pigs each. Selective ischemia time was recorded and the vascular occlusion site was noted radiographically and laparoscopically. The feasibility of reversing the polymer from solid back to liquid state to allow reperfusion was determined. Pathological analysis of the kidney was completed in these acute model pigs. In the last 2 cases lower pole robotic partial nephrectomy was done using the da Vinci surgical system. RESULTS: Selective lower pole ischemia was achieved in all 8 cases. Perfusion hemostasis yielded an inconsistent duration of occlusion (zero to greater than 60 minutes). Vascular occlusion time using local plug formation was more reliable (17 to 30 minutes) with consistent ability to reverse the plug to liquid state by cold saline flush. Two lower pole robotic partial nephrectomies were completed with minimal blood loss. CONCLUSIONS: We developed a reliable technique of angiographic delivery of gel polymer for temporary vascular occlusion of selective renal artery branches using local plug formation. Ongoing studies are under way to assess technique consistency and the long-term effects of the polymer. |
| | |
Authors:
|
Alireza Moinzadeh; Sebastian Flacke; John A Libertino; John Merhige; Jean-Marie Vogel; Katy Lyall; Curtis W Bakal; Peter N Madras |
Related Documents
:
|
18289449 - Midazolam inhibits cardiac nociception evoked by coronary artery occlusion in rats. 1675639 - Intracarotid infusion of leukotriene c4 selectively increases blood-brain barrier perme... 19709959 - Targeted venous occlusion using pulsed high-intensity focused ultrasound. 20824749 - Subintimal angioplasty with a true reentry device for treatment of chronic total occlus... 2003289 - Basilar artery occlusion in rats. 18155249 - Matrix metalloproteinases in critical limb ischemia. 3675259 - Alexia without agraphia in a left-handed patient with a right occipital lesion. 21483129 - Transarterial onyx embolization of sagittal sinus dural arteriovenous fistulae. 9152309 - Anti-p-selectin antibody decreases inflammation and thrombus formation in venous thromb... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-08-15 |
Journal Detail:
|
Title: The Journal of urology Volume: 182 ISSN: 1527-3792 ISO Abbreviation: J. Urol. Publication Date: 2009 Oct |
Date Detail:
|
Created Date: 2009-09-14 Completed Date: 2009-10-02 Revised Date: 2010-09-22 |
Medline Journal Info:
|
Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
|
Languages: eng Pagination: 1582-7 Citation Subset: AIM; IM |
Affiliation:
|
Lahey Clinic, Burlington and Pluromed, Inc., Woburn, Massachusetts 01805, USA. moinza00@lahey.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Blood Loss, Surgical / prevention & control* Embolization, Therapeutic / methods* Feasibility Studies Hemostasis, Surgical / methods* Laparoscopy* Nephrectomy / methods* Poloxamer* Renal Artery* Robotics* Swine Time Factors |
| Grant Support | |
ID/Acronym/Agency:
|
1R43DK079481-01/DK/NIDDK NIH HHS; R43 DK079481-01/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/LeGoo; 106392-12-5/Poloxamer |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Renal transplant recipients and patients with end stage renal disease present with more advanced bla...
Next Document: Laparoscopy assisted versus open ileocystoplasty in pigs.