Document Detail


Use of fibrin glue and gelfoam to repair collecting system injuries in a porcine model: implications for the technique of laparoscopic partial nephrectomy.
MedLine Citation:
PMID:  14642047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: One of the challenges of laparoscopic partial nephrectomies is the repair of a collecting system injury. We hypothesized that fibrin glue plus Gelfoam could be sufficient to repair such injuries. MATERIALS AND METHODS: Four pigs (eight kidneys) underwent collecting system injuries of various lengths (3, 5, and 10 mm) (N = 8 each) during partial nephrectomy. Gelfoam soaked in the fibrin glue was applied to seal the collecting system and parenchymal defects. After 1 hour of passive filling, the renal pelvis was distended at supraphysiologic pressure to the point of leakage. Each repair site was examined for urinary extravasation during the physiologic and active phases of filling. RESULTS: Hemostasis was achieved, and all collecting system injuries, regardless of size, were free of urinary leakage at physiologic pressures. Moreover, all defects maintained a seal at supraphysiologic pressures of at least 50 cm H(2)O. CONCLUSION: The combined use of fibrin glue and Gelfoam is an effective means to obtain hemostasis and seal collecting system injuries up to 10 mm at physiologic pressures and up to 50 cm H(2)O in the acute setting. Our hope is that this technique can facilitate both laparoscopic and open partial nephrectomies. New technologies will be employed in an attempt to obtain better seating of the sealant plug in the future. Survival studies are in progress.
Authors:
Rupa Patel; Robert P Caruso; Samir Taneja; Michael Stifelman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  17     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-06-21     Revised Date:  2006-04-13    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  799-804     Citation Subset:  IM    
Affiliation:
Department of Urology, New York University School of Medicine, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Female
Fibrin Tissue Adhesive*
Gelatin Sponge, Absorbable*
Hemostatic Techniques
Kidney Tubules, Collecting / injuries*,  surgery*
Laparoscopy*
Nephrectomy / methods*
Swine
Chemical
Reg. No./Substance:
0/Fibrin Tissue Adhesive

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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