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Related Experiment Videos

Improved hemostasis during laparoscopic partial nephrectomy using gelatin matrix thrombin sealant.

Inderbir S Gill1, Anup P Ramani, Massimiliano Spaliviero

  • 1Section of Laparoscopic and Robotic Surgery, Glickman Urological Institute and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. gilli@ccf.org

Urology
|March 23, 2005
PubMed
Summary

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Biologic hemostatic sealant (FloSeal) significantly reduced complications in laparoscopic partial nephrectomy. This topical sealant improved parenchymal hemostasis, making it a routine part of the procedure.

Area of Science:

  • Urology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Laparoscopic partial nephrectomy requires secure parenchymal hemostasis.
  • Achieving durable hemostasis is critical for minimizing complications.

Purpose of the Study:

  • To evaluate the efficacy of a biologic hemostatic sealant in facilitating hemostasis during laparoscopic partial nephrectomy.
  • To assess the impact of gelatin matrix thrombin sealant (FloSeal) on reducing hemorrhagic complications.

Main Methods:

  • A retrospective comparison of two patient groups undergoing laparoscopic partial nephrectomy by a single surgeon.
  • Group 1 (n=68): no sealant. Group 2 (n=63): topical application of FloSeal before renorrhaphy.
  • Comparison of intraoperative variables and postoperative complications between the groups.

Related Experiment Videos

Main Results:

  • Groups were comparable in tumor characteristics and pelvicaliceal repair rates.
  • No significant differences in warm ischemia time, blood loss, operative time, or hospital stay.
  • The FloSeal group showed significantly fewer overall complications (16% vs 37%; P=0.008) and a trend towards lower hemorrhagic complications (3% vs 12%; P=0.08).

Conclusions:

  • Adjunctive use of gelatin matrix thrombin sealant (FloSeal) substantially enhances parenchymal hemostasis.
  • The sealant decreased procedural and hemorrhagic complications.
  • FloSeal is now routinely used in laparoscopic partial nephrectomy at the institution.