Document Detail


Use of titanium staples during upper tract laparoscopic reconstructive surgery: initial experience.
MedLine Citation:
PMID:  12352394     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Using nonabsorbable titanium staples in the lower urinary tract during laparoscopic nephroureterectomy has been shown to be safe. Laboratory studies of titanium staples in the upper urinary tract have likewise been favorable. Therefore, we used titanium Endo-GIA tissue staples (United States Surgical, Norwalk, Connecticut) to facilitate laparoscopic reduction pelvioplasty during laparoscopic pyeloplasty. MATERIALS AND METHODS: Of the 17 cases of reduction pelvioplasty closure was done in 12 using absorbable sutures, while in 5 reduction was done with an Endo-GIA stapler. Followup consisted of office visits and telephone interviews plus radionuclide renal scans. RESULTS: Average operative time was 5.5 hours in the Endo-GIA group compared with 6.8 hours in the sutured group. In the latter group extravasation in 2 patients postoperatively was managed conservatively. There was no extravasation in the stapled group. At a median subjective followup of 27 months none of the 5 patients who underwent reduction with titanium staples had symptomatic nephrolithiasis, although new onset urolithiasis developed in 1 in the sutured group. All patients had a greater than 50% decrease in pain. Renal scans at a median of 9 months showed that all ureteropelvic junction repairs were unobstructed. Additional radiographic studies in 2 patients in the stapled group showed a patent ureteropelvic junction and no stones. CONCLUSIONS: Titanium staples provide rapid, secure closure of the renal pelvis during laparoscopic pyeloplasty. While the risk of stone formation is an ongoing concern, it has yet to materialize.
Authors:
Robert L Grubb; Chandru P Sundaram; Yan Yan; Cathy Chen; Elspeth M McDougall; Ralph V Clayman
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  168     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-27     Completed Date:  2002-10-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1366-9     Citation Subset:  AIM; IM    
Affiliation:
SDepartment of Surgery (Urology), Washington University School of Medicine, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Kidney Pelvis / surgery*
Laparoscopy*
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Postoperative Complications / etiology,  surgery
Reoperation
Surgical Instruments
Surgical Staplers*
Suture Techniques
Titanium*
Ureteral Obstruction / surgery*
Chemical
Reg. No./Substance:
7440-32-6/Titanium

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


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