Sprayed Fibrin Sealant as the Sole Hemostatic Agent for Porcine Laparoscopic Partial Nephrectomy

Abstract

No AccessJournal of UrologyInvestigative Urology1 Jan 2011Sprayed Fibrin Sealant as the Sole Hemostatic Agent for Porcine Laparoscopic Partial Nephrectomy Donald Lowell Pick, Surendra B. Kolla, Phillip Mucksavage, Michael K. Louie, Petros Sountoulides, Oskar Kaufmann, Stephania Olamendi, Adam Kaplan, Victor Huynh, Cervando Ortiz-Vanderdys, Hung P. Truong, Shary A. Said, Lorena Andrade, Jane Tongson-Ignacio, Elspeth M. McDougall, and Ralph V. Clayman Donald Lowell PickDonald Lowell Pick , Surendra B. KollaSurendra B. Kolla , Phillip MucksavagePhillip Mucksavage , Michael K. LouieMichael K. Louie , Petros SountoulidesPetros Sountoulides , Oskar KaufmannOskar Kaufmann , Stephania OlamendiStephania Olamendi , Adam KaplanAdam Kaplan , Victor HuynhVictor Huynh , Cervando Ortiz-VanderdysCervando Ortiz-Vanderdys , Hung P. TruongHung P. Truong , Shary A. SaidShary A. Said , Lorena AndradeLorena Andrade , Jane Tongson-IgnacioJane Tongson-Ignacio , Elspeth M. McDougallElspeth M. McDougall , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.002AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Tisseel® is used to control minor bleeding during laparoscopic procedures. The DuploSpray MIS™ spray system allows thin, even application over a larger surface area. We use sprayed Tisseel as the sole agent to control hemorrhage and seal the renal collecting system after severe porcine laparoscopic partial nephrectomy. Methods and Materials: We performed staged bilateral severe laparoscopic partial nephrectomy in 12 Yucatan pigs using a longitudinal cut from upper to lower pole through the entire collecting system. In each pig 1 kidney was harvested immediately while the other was harvested after 4 weeks. After hilar clamping laparoscopic partial nephrectomy was done with cold scissors in 6 pigs while LigaSure™ was used in the other 6. Sprayed Tisseel was applied, and bleeding and urinary leakage were evaluated. Additional Tisseel was applied for repeat bleeding. We performed retrograde pyelogram (chronic) and burst pressure testing of the arterial and collecting systems. Results: All animals survived 4 weeks. One urinoma was seen on retrograde pyelogram in the cold cut group. Average hilar clamp time was similar in the acute and chronic study arms. Average estimated blood loss was significantly less in the LigaSure group (p = 0.0045). Average arterial burst pressure was significantly different in the chronic and acute groups (605.8 vs 350.4 mm Hg, p = 0.008) but average collecting system burst pressure was similar (186.3 and 149.5 mm Hg, respectively). 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Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byPloussard G, Haddad R, Loutochin O, Bera R, Cabrera T, Malibari N, Scarlata E, Derbekyan V, Bladou F and Anidjar M (2018) A Combination of Hemostatic Agents May Safely Replace Deep Medullary Suture during Laparoscopic Partial Nephrectomy in a Pig ModelJournal of Urology, VOL. 193, NO. 1, (318-324), Online publication date: 1-Jan-2015. Volume 185Issue 1January 2011Page: 291-297 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsfibrin tissue adhesivelaparoscopykidneynephrectomyswineMetricsAuthor Information Donald Lowell Pick More articles by this author Surendra B. Kolla More articles by this author Phillip Mucksavage More articles by this author Michael K. Louie More articles by this author Petros Sountoulides More articles by this author Oskar Kaufmann More articles by this author Stephania Olamendi More articles by this author Adam Kaplan More articles by this author Victor Huynh More articles by this author Cervando Ortiz-Vanderdys More articles by this author Hung P. Truong More articles by this author Shary A. Said More articles by this author Lorena Andrade More articles by this author Jane Tongson-Ignacio More articles by this author Elspeth M. McDougall Financial interest and/or other relationship with Endocare, METI, Simbionix, Intuitive Surgical, Ethicon Endo-Surgery, Karl Storz Endoscopy America and Omeros. More articles by this author Ralph V. Clayman Financial interest and/or other relationship with Cook Urological, Applied Urology, Intuitive, Omeros, Cook Urological, Greenwald, Orthopedic Service, Galil Medical, Boston Scientific, Vascular Technology and Karl Storz. 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