Use of Gelatin Matrix Thrombin Tissue Sealant as an Effective Hemostatic Agent During Laparoscopic Partial Nephrectomy

No AccessJournal of UrologyCLINICAL UROLOGY: Urologists at Work1 Feb 2004Use of Gelatin Matrix Thrombin Tissue Sealant as an Effective Hemostatic Agent During Laparoscopic Partial Nephrectomy JOHN B. BAK, AMAR SINGH, and BIJAN SHEKARRIZ JOHN B. BAKJOHN B. BAK More articles by this author , AMAR SINGHAMAR SINGH More articles by this author , and BIJAN SHEKARRIZBIJAN SHEKARRIZ More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000104800.97009.c6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We describe a technique for achieving effective hemostasis during laparoscopic partial nephrectomy using gelatin matrix thrombin tissue sealant. Materials and Methods: Between June 2002 and April 2003, 6 patients underwent laparoscopic partial nephrectomy using the 2-component tissue sealant. Median patient age was 59 years (range 28 to 71) and followup time ranged from 1 to 10 months (median 4.3). The tumor was at least 50% exophytic on preoperative computerized tomography and the diameter ranged from 2 to 3 cm (median 2.5). The 2-component tissue sealant, consisting of a gelatin matrix granula component and a thrombin component, was applied after resection of the tumor and before reperfusion of the kidney. Time until complete hemostasis was achieved, postoperative bleeding, estimated blood loss, warm ischemia time and length of surgery were recorded. Results: Hemostasis was immediate in all cases after application of the tissue sealant for 1 to 2 minutes to the moist resection site. The laparoscopic applicator was used to apply the material to the renal parenchyma. Hemostasis was maintained when reperfusion of the kidney was established. Estimated blood loss ranged from 50 to 350 cc (median 200), and no patient required blood transfusion. Length of surgery ranged from 89 to 230 minutes (median 189), and warm ischemia time ranged from 10 to 14 minutes (median 13). No postoperative bleeding occurred. Conclusions: The 2-component tissue sealant provided immediate and durable hemostasis in laparoscopic partial nephrectomy. It is a safe and time sparing alternative adjunct to currently available means of achieving hemostasis. In a select patient population use of this agent may reduce warm ischemia time by circumventing the need to perform laparoscopic suturing. References 1 : Laparoscopic partial nephrectomy for renal tumor: duplicating open surgical techniques. J Urol2002; 167: 469. Link, Google Scholar 2 : The use of fibrin sealant in urology. J Urol2002; 167: 1218. Link, Google Scholar 3 : Use of FloSeal hemostatic sealant in transsphenoidal pituitary surgery: technical note. Neurosurgery2002; 51: 513. Google Scholar 4 Summary of safety and effectiveness: FloSeal® matrix hemostatic sealant. 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Google Scholar From the Department of Urology, State University of New York, Upstate Medical University, Syracuse, New York© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byCadeddu J (2016) Re: Omission of Hemostatic Agents during Robotic Partial Nephrectomy Does Not Increase Postoperative Bleeding RiskJournal of Urology, VOL. 197, NO. 3 Part 1, (604-604), Online publication date: 1-Mar-2017.Hong Y and Loughlin K (2018) The Use of Hemostatic Agents and Sealants in UrologyJournal of Urology, VOL. 176, NO. 6, (2367-2374), Online publication date: 1-Dec-2006.Johnston W, Kelel K, Hollenbeck B, Daignault S and Wolf J (2018) Acute Integrity of Closure for Partial Nephrectomy: Comparison of 7 Agents in a Hypertensive Porcine ModelJournal of Urology, VOL. 175, NO. 6, (2307-2311), Online publication date: 1-Jun-2006.MARGULIS V, MATSUMOTO E, SVATEK R, KABBANI W, CADEDDU J and LOTAN Y (2018) APPLICATION OF NOVEL HEMOSTATIC AGENT DURING LAPAROSCOPIC PARTIAL NEPHRECTOMYJournal of Urology, VOL. 174, NO. 2, (761-764), Online publication date: 1-Aug-2005.JOHNSTON W, MONTGOMERY J, SEIFMAN B, HOLLENBECK B and WOLF J (2018) FIBRIN GLUE V SUTURED BOLSTER: LESSONS LEARNED DURING 100 LAPAROSCOPIC PARTIAL NEPHRECTOMIESJournal of Urology, VOL. 174, NO. 1, (47-52), Online publication date: 1-Jul-2005.HICK E, MOREY A, HARRIS R and MORRIS M (2018) GELATIN MATRIX TREATMENT OF COMPLEX RENAL INJURIES IN A PORCINE MODELJournal of Urology, VOL. 173, NO. 5, (1801-1804), Online publication date: 1-May-2005. Volume 171Issue 2February 2004Page: 780-782 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordslaparoscopythrombinnephrectomyfibrin tissue adhesiveMetricsAuthor Information JOHN B. BAK More articles by this author AMAR SINGH More articles by this author BIJAN SHEKARRIZ More articles by this author Expand All Advertisement PDF downloadLoading ...