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Tubeless percutaneous nephrolithotomy using hemostatic gelatin matrix
James F Borin1, Leandro G Sala, Louis Eichel
1Department of Urology, University of California, Irvine, Orange, California 92612, USA.
Journal of Endourology
|August 2, 2005
Summary
This study introduces a novel technique using hemostatic gelatin matrix (FloSeal) to seal the tract after percutaneous nephrolithotomy, eliminating the need for a nephrostomy tube and enabling same-day discharge.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Biomaterials
Background:
- Percutaneous nephrolithotomy (PCNL) often requires a nephrostomy tube for tract hemostasis.
- Nephrostomy tubes can cause patient discomfort and increase the risk of complications.
- Alternative methods for tract closure and hemostasis are desirable.
Purpose of the Study:
- To describe a novel technique for achieving hemostasis of the percutaneous nephrolithotomy tract.
- To evaluate the feasibility of obviating a nephrostomy tube using hemostatic gelatin matrix.
- To assess the potential for early patient discharge after PCNL.
Main Methods:
- Hemostatic gelatin matrix (FloSeal) was injected into the tract after PCNL.
- An occlusion balloon catheter was used to occlude the collecting system during matrix injection.
- The Amplatz sheath was withdrawn in tandem with the applicator.
- A ureteral stent and Foley catheter were placed; the Foley catheter was removed the next morning.
Main Results:
- The described technique successfully provided hemostasis of the tract.
- Nephrostomy tubes were obviated in patients treated with this method.
- Patients were discharged on postoperative day 1.
Conclusions:
- Hemostatic gelatin matrix (FloSeal) is a viable option for tract hemostasis after PCNL.
- This technique allows for the elimination of nephrostomy tubes.
- The method facilitates early ambulation and discharge, improving patient recovery.