Laparoscopic heminephrectomy using a new fibrin sealant powder

Jay T. Bishoff, Rhonda L. Cornum, Barak Perahia, Thomas Seay, Stephen Eliason, Mathew Katus, Alan Morey, Vincent Gresham, Anthony Pusateri, Lara A. Murcin, David Tuthill, Stanley Friedman

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives. To determine the ability of a hemostatic fibrin sealant powder (HFSP), delivered laparoscopically, to achieve hemostasis and seal the collecting system during laparoscopic heminephrectomy. Methods. An HFSP preparation was applied laparoscopically as a dry powder spray. Twenty-two farm pigs were randomized into two laparoscopic heminephrectomy groups: group 1 underwent conventional intracorporal suturing with vascular control (n = 11) and group 2 received HFSP application alone with regional ischemia (n = 11). Computed tomography was performed at 48 hours and again 6 weeks postoperatively. Results. The operative findings revealed no differences between the two groups in the weight of the removed segments, mean arterial blood pressure, operating room time, estimated blood loss, or hematocrit and serum creatinine levels. The gross examination 6 weeks postoperatively found no delayed bleeding, urinoma formation, or bowel adhesions. The computed tomography findings at 48 hours postoperatively demonstrated excellent hemostasis in both groups. Urinary extravasation was detected in 8 (80%) of 10 animals in the HFSP group and 1 (9%) of 11 in the conventional group at 48 hours (P < 0.008). At the 6-week computed tomography evaluation, none of the animals showed evidence of urinoma or hematoma formation. Histopathologically, at 6 weeks, the cut surface of the kidneys in both groups had been replaced by dense scar tissue at the cortex with a sharp line of demarcation between the scar and normal kidney. Conclusions. HFSP greatly facilitates laparoscopic heminephrectomy by providing rapid and lasting hemostasis without suturing. Early urine extravasation was more common in the HFSP group, but no clinical, gross, or radiographic evidence of urinoma formation was seen in either group 6 weeks after surgery.

Original languageEnglish (US)
Pages (from-to)1139-1143
Number of pages5
JournalUrology
Volume62
Issue number6
DOIs
StatePublished - Dec 2003

Fingerprint

Fibrin Tissue Adhesive
Nephrectomy
Powders
Hemostatics
Urinoma
Hemostasis
Tomography
Cicatrix
Arterial Pressure
Kidney
Operating Rooms
Hematocrit
Hematoma
Blood Vessels
Creatinine
Swine
Ischemia
Urine
Hemorrhage
Weights and Measures

ASJC Scopus subject areas

  • Urology

Cite this

Bishoff, J. T., Cornum, R. L., Perahia, B., Seay, T., Eliason, S., Katus, M., ... Friedman, S. (2003). Laparoscopic heminephrectomy using a new fibrin sealant powder. Urology, 62(6), 1139-1143. https://doi.org/10.1016/S0090-4295(03)00783-0

Laparoscopic heminephrectomy using a new fibrin sealant powder. / Bishoff, Jay T.; Cornum, Rhonda L.; Perahia, Barak; Seay, Thomas; Eliason, Stephen; Katus, Mathew; Morey, Alan; Gresham, Vincent; Pusateri, Anthony; Murcin, Lara A.; Tuthill, David; Friedman, Stanley.

In: Urology, Vol. 62, No. 6, 12.2003, p. 1139-1143.

Research output: Contribution to journalArticle

Bishoff, JT, Cornum, RL, Perahia, B, Seay, T, Eliason, S, Katus, M, Morey, A, Gresham, V, Pusateri, A, Murcin, LA, Tuthill, D & Friedman, S 2003, 'Laparoscopic heminephrectomy using a new fibrin sealant powder', Urology, vol. 62, no. 6, pp. 1139-1143. https://doi.org/10.1016/S0090-4295(03)00783-0
Bishoff JT, Cornum RL, Perahia B, Seay T, Eliason S, Katus M et al. Laparoscopic heminephrectomy using a new fibrin sealant powder. Urology. 2003 Dec;62(6):1139-1143. https://doi.org/10.1016/S0090-4295(03)00783-0
Bishoff, Jay T. ; Cornum, Rhonda L. ; Perahia, Barak ; Seay, Thomas ; Eliason, Stephen ; Katus, Mathew ; Morey, Alan ; Gresham, Vincent ; Pusateri, Anthony ; Murcin, Lara A. ; Tuthill, David ; Friedman, Stanley. / Laparoscopic heminephrectomy using a new fibrin sealant powder. In: Urology. 2003 ; Vol. 62, No. 6. pp. 1139-1143.
@article{751f872704d24b9b91c8d74f59383ce5,
title = "Laparoscopic heminephrectomy using a new fibrin sealant powder",
abstract = "Objectives. To determine the ability of a hemostatic fibrin sealant powder (HFSP), delivered laparoscopically, to achieve hemostasis and seal the collecting system during laparoscopic heminephrectomy. Methods. An HFSP preparation was applied laparoscopically as a dry powder spray. Twenty-two farm pigs were randomized into two laparoscopic heminephrectomy groups: group 1 underwent conventional intracorporal suturing with vascular control (n = 11) and group 2 received HFSP application alone with regional ischemia (n = 11). Computed tomography was performed at 48 hours and again 6 weeks postoperatively. Results. The operative findings revealed no differences between the two groups in the weight of the removed segments, mean arterial blood pressure, operating room time, estimated blood loss, or hematocrit and serum creatinine levels. The gross examination 6 weeks postoperatively found no delayed bleeding, urinoma formation, or bowel adhesions. The computed tomography findings at 48 hours postoperatively demonstrated excellent hemostasis in both groups. Urinary extravasation was detected in 8 (80{\%}) of 10 animals in the HFSP group and 1 (9{\%}) of 11 in the conventional group at 48 hours (P < 0.008). At the 6-week computed tomography evaluation, none of the animals showed evidence of urinoma or hematoma formation. Histopathologically, at 6 weeks, the cut surface of the kidneys in both groups had been replaced by dense scar tissue at the cortex with a sharp line of demarcation between the scar and normal kidney. Conclusions. HFSP greatly facilitates laparoscopic heminephrectomy by providing rapid and lasting hemostasis without suturing. Early urine extravasation was more common in the HFSP group, but no clinical, gross, or radiographic evidence of urinoma formation was seen in either group 6 weeks after surgery.",
author = "Bishoff, {Jay T.} and Cornum, {Rhonda L.} and Barak Perahia and Thomas Seay and Stephen Eliason and Mathew Katus and Alan Morey and Vincent Gresham and Anthony Pusateri and Murcin, {Lara A.} and David Tuthill and Stanley Friedman",
year = "2003",
month = "12",
doi = "10.1016/S0090-4295(03)00783-0",
language = "English (US)",
volume = "62",
pages = "1139--1143",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Laparoscopic heminephrectomy using a new fibrin sealant powder

AU - Bishoff, Jay T.

AU - Cornum, Rhonda L.

AU - Perahia, Barak

AU - Seay, Thomas

AU - Eliason, Stephen

AU - Katus, Mathew

AU - Morey, Alan

AU - Gresham, Vincent

AU - Pusateri, Anthony

AU - Murcin, Lara A.

AU - Tuthill, David

AU - Friedman, Stanley

PY - 2003/12

Y1 - 2003/12

N2 - Objectives. To determine the ability of a hemostatic fibrin sealant powder (HFSP), delivered laparoscopically, to achieve hemostasis and seal the collecting system during laparoscopic heminephrectomy. Methods. An HFSP preparation was applied laparoscopically as a dry powder spray. Twenty-two farm pigs were randomized into two laparoscopic heminephrectomy groups: group 1 underwent conventional intracorporal suturing with vascular control (n = 11) and group 2 received HFSP application alone with regional ischemia (n = 11). Computed tomography was performed at 48 hours and again 6 weeks postoperatively. Results. The operative findings revealed no differences between the two groups in the weight of the removed segments, mean arterial blood pressure, operating room time, estimated blood loss, or hematocrit and serum creatinine levels. The gross examination 6 weeks postoperatively found no delayed bleeding, urinoma formation, or bowel adhesions. The computed tomography findings at 48 hours postoperatively demonstrated excellent hemostasis in both groups. Urinary extravasation was detected in 8 (80%) of 10 animals in the HFSP group and 1 (9%) of 11 in the conventional group at 48 hours (P < 0.008). At the 6-week computed tomography evaluation, none of the animals showed evidence of urinoma or hematoma formation. Histopathologically, at 6 weeks, the cut surface of the kidneys in both groups had been replaced by dense scar tissue at the cortex with a sharp line of demarcation between the scar and normal kidney. Conclusions. HFSP greatly facilitates laparoscopic heminephrectomy by providing rapid and lasting hemostasis without suturing. Early urine extravasation was more common in the HFSP group, but no clinical, gross, or radiographic evidence of urinoma formation was seen in either group 6 weeks after surgery.

AB - Objectives. To determine the ability of a hemostatic fibrin sealant powder (HFSP), delivered laparoscopically, to achieve hemostasis and seal the collecting system during laparoscopic heminephrectomy. Methods. An HFSP preparation was applied laparoscopically as a dry powder spray. Twenty-two farm pigs were randomized into two laparoscopic heminephrectomy groups: group 1 underwent conventional intracorporal suturing with vascular control (n = 11) and group 2 received HFSP application alone with regional ischemia (n = 11). Computed tomography was performed at 48 hours and again 6 weeks postoperatively. Results. The operative findings revealed no differences between the two groups in the weight of the removed segments, mean arterial blood pressure, operating room time, estimated blood loss, or hematocrit and serum creatinine levels. The gross examination 6 weeks postoperatively found no delayed bleeding, urinoma formation, or bowel adhesions. The computed tomography findings at 48 hours postoperatively demonstrated excellent hemostasis in both groups. Urinary extravasation was detected in 8 (80%) of 10 animals in the HFSP group and 1 (9%) of 11 in the conventional group at 48 hours (P < 0.008). At the 6-week computed tomography evaluation, none of the animals showed evidence of urinoma or hematoma formation. Histopathologically, at 6 weeks, the cut surface of the kidneys in both groups had been replaced by dense scar tissue at the cortex with a sharp line of demarcation between the scar and normal kidney. Conclusions. HFSP greatly facilitates laparoscopic heminephrectomy by providing rapid and lasting hemostasis without suturing. Early urine extravasation was more common in the HFSP group, but no clinical, gross, or radiographic evidence of urinoma formation was seen in either group 6 weeks after surgery.

UR - http://www.scopus.com/inward/record.url?scp=0344234450&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0344234450&partnerID=8YFLogxK

U2 - 10.1016/S0090-4295(03)00783-0

DO - 10.1016/S0090-4295(03)00783-0

M3 - Article

C2 - 14665378

AN - SCOPUS:0344234450

VL - 62

SP - 1139

EP - 1143

JO - Urology

JF - Urology

SN - 0090-4295

IS - 6

ER -