Application of novel hemostatic agent during laparoscopic partial nephrectomy

Vitaly Margulis, Edward D. Matsumoto, Robert Svatek, Wareef Kabbani, Jeffrey A Cadeddu, Yair Lotan

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: We determined if QuikClot®, a novel hemostatic agent made of a granulated mineral substance, could be used to control renal parenchymal bleeding and collecting system leakage during open and laparoscopic partial nephrectomy. Materials and Methods: After obtaining renal hilar vascular control 2 domestic female pigs underwent bilateral open and 4 underwent unilateral laparoscopic partial nephrectomy. After excision of the lower pole without cautery the hemostatic agent was applied to the cut surface of the kidney and hilar vascular control was released. Additional QuikClot® was added until complete hemostasis was achieved. One week postoperatively the animals were sacrificed and the operated kidneys were harvested for ex vivo retrograde pyelograms and histopathological analysis. Results: All partial nephrectomies were performed without complication. Mean operative and warm ischemia times were 62 and 16 minutes, respectively. An average of 23% of renal mass by weight was resected with a mean blood loss of 73 ml per procedure. No cautery, additional hemostatic agents or techniques were used. No animal had clinical or radiographic evidence of urinoma or delayed hemorrhage. Histopathological analysis showed preservation of the renal parenchyma immediately beneath the QuikClot® layer. Conclusions: In the porcine model QuikClot® allowed the resection of large renal segments, while providing reliable hemostasis and closure of the renal collecting system. No deleterious effect on underlying renal parenchyma or surrounding tissues was observed.

Original languageEnglish (US)
Pages (from-to)761-764
Number of pages4
JournalJournal of Urology
Volume174
Issue number2
DOIs
StatePublished - Aug 2005

Fingerprint

Hemostatics
Nephrectomy
Kidney
Cautery
Hemostasis
Blood Vessels
Urinoma
Hemorrhage
Warm Ischemia
Sus scrofa
Urography
Minerals
Swine
Weights and Measures

Keywords

  • Hemostasis
  • Kidney
  • Laparoscopy
  • Nephrectomy
  • Swine

ASJC Scopus subject areas

  • Urology

Cite this

Application of novel hemostatic agent during laparoscopic partial nephrectomy. / Margulis, Vitaly; Matsumoto, Edward D.; Svatek, Robert; Kabbani, Wareef; Cadeddu, Jeffrey A; Lotan, Yair.

In: Journal of Urology, Vol. 174, No. 2, 08.2005, p. 761-764.

Research output: Contribution to journalArticle

Margulis, Vitaly ; Matsumoto, Edward D. ; Svatek, Robert ; Kabbani, Wareef ; Cadeddu, Jeffrey A ; Lotan, Yair. / Application of novel hemostatic agent during laparoscopic partial nephrectomy. In: Journal of Urology. 2005 ; Vol. 174, No. 2. pp. 761-764.
@article{8421087286cc4056a41fd200c62a86e2,
title = "Application of novel hemostatic agent during laparoscopic partial nephrectomy",
abstract = "Purpose: We determined if QuikClot{\circledR}, a novel hemostatic agent made of a granulated mineral substance, could be used to control renal parenchymal bleeding and collecting system leakage during open and laparoscopic partial nephrectomy. Materials and Methods: After obtaining renal hilar vascular control 2 domestic female pigs underwent bilateral open and 4 underwent unilateral laparoscopic partial nephrectomy. After excision of the lower pole without cautery the hemostatic agent was applied to the cut surface of the kidney and hilar vascular control was released. Additional QuikClot{\circledR} was added until complete hemostasis was achieved. One week postoperatively the animals were sacrificed and the operated kidneys were harvested for ex vivo retrograde pyelograms and histopathological analysis. Results: All partial nephrectomies were performed without complication. Mean operative and warm ischemia times were 62 and 16 minutes, respectively. An average of 23{\%} of renal mass by weight was resected with a mean blood loss of 73 ml per procedure. No cautery, additional hemostatic agents or techniques were used. No animal had clinical or radiographic evidence of urinoma or delayed hemorrhage. Histopathological analysis showed preservation of the renal parenchyma immediately beneath the QuikClot{\circledR} layer. Conclusions: In the porcine model QuikClot{\circledR} allowed the resection of large renal segments, while providing reliable hemostasis and closure of the renal collecting system. No deleterious effect on underlying renal parenchyma or surrounding tissues was observed.",
keywords = "Hemostasis, Kidney, Laparoscopy, Nephrectomy, Swine",
author = "Vitaly Margulis and Matsumoto, {Edward D.} and Robert Svatek and Wareef Kabbani and Cadeddu, {Jeffrey A} and Yair Lotan",
year = "2005",
month = "8",
doi = "10.1097/01.ju.0000164727.53999.fe",
language = "English (US)",
volume = "174",
pages = "761--764",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Application of novel hemostatic agent during laparoscopic partial nephrectomy

AU - Margulis, Vitaly

AU - Matsumoto, Edward D.

AU - Svatek, Robert

AU - Kabbani, Wareef

AU - Cadeddu, Jeffrey A

AU - Lotan, Yair

PY - 2005/8

Y1 - 2005/8

N2 - Purpose: We determined if QuikClot®, a novel hemostatic agent made of a granulated mineral substance, could be used to control renal parenchymal bleeding and collecting system leakage during open and laparoscopic partial nephrectomy. Materials and Methods: After obtaining renal hilar vascular control 2 domestic female pigs underwent bilateral open and 4 underwent unilateral laparoscopic partial nephrectomy. After excision of the lower pole without cautery the hemostatic agent was applied to the cut surface of the kidney and hilar vascular control was released. Additional QuikClot® was added until complete hemostasis was achieved. One week postoperatively the animals were sacrificed and the operated kidneys were harvested for ex vivo retrograde pyelograms and histopathological analysis. Results: All partial nephrectomies were performed without complication. Mean operative and warm ischemia times were 62 and 16 minutes, respectively. An average of 23% of renal mass by weight was resected with a mean blood loss of 73 ml per procedure. No cautery, additional hemostatic agents or techniques were used. No animal had clinical or radiographic evidence of urinoma or delayed hemorrhage. Histopathological analysis showed preservation of the renal parenchyma immediately beneath the QuikClot® layer. Conclusions: In the porcine model QuikClot® allowed the resection of large renal segments, while providing reliable hemostasis and closure of the renal collecting system. No deleterious effect on underlying renal parenchyma or surrounding tissues was observed.

AB - Purpose: We determined if QuikClot®, a novel hemostatic agent made of a granulated mineral substance, could be used to control renal parenchymal bleeding and collecting system leakage during open and laparoscopic partial nephrectomy. Materials and Methods: After obtaining renal hilar vascular control 2 domestic female pigs underwent bilateral open and 4 underwent unilateral laparoscopic partial nephrectomy. After excision of the lower pole without cautery the hemostatic agent was applied to the cut surface of the kidney and hilar vascular control was released. Additional QuikClot® was added until complete hemostasis was achieved. One week postoperatively the animals were sacrificed and the operated kidneys were harvested for ex vivo retrograde pyelograms and histopathological analysis. Results: All partial nephrectomies were performed without complication. Mean operative and warm ischemia times were 62 and 16 minutes, respectively. An average of 23% of renal mass by weight was resected with a mean blood loss of 73 ml per procedure. No cautery, additional hemostatic agents or techniques were used. No animal had clinical or radiographic evidence of urinoma or delayed hemorrhage. Histopathological analysis showed preservation of the renal parenchyma immediately beneath the QuikClot® layer. Conclusions: In the porcine model QuikClot® allowed the resection of large renal segments, while providing reliable hemostasis and closure of the renal collecting system. No deleterious effect on underlying renal parenchyma or surrounding tissues was observed.

KW - Hemostasis

KW - Kidney

KW - Laparoscopy

KW - Nephrectomy

KW - Swine

UR - http://www.scopus.com/inward/record.url?scp=22144482711&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=22144482711&partnerID=8YFLogxK

U2 - 10.1097/01.ju.0000164727.53999.fe

DO - 10.1097/01.ju.0000164727.53999.fe

M3 - Article

VL - 174

SP - 761

EP - 764

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -