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Related Experiment Videos

Haemostasis in laparoscopic partial nephrectomy: current status.

Jessica H van Dijk1, Pilar Laguna M Pes

  • 1Department of Urology, Academisch Medischs Centrum, University of Amsterdam, Amsterdam, the Netherlands.

Minimally Invasive Therapy & Allied Technologies : MITAT : Official Journal of the Society for Minimally Invasive Therapy
|March 17, 2007
PubMed
Summary
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Achieving effective hemostasis during laparoscopic partial nephrectomy (LPN) involves adapting open surgical techniques. Renal ischemia and bolster sutures are crucial for complex cases, while sealants suffice for small tumors.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Hemostasis

Background:

  • Laparoscopic partial nephrectomy (LPN) is a common procedure.
  • Achieving adequate hemostasis during LPN can be challenging, similar to open surgery.

Purpose of the Study:

  • To review and describe various hemostatic methods used in LPN.
  • To categorize techniques into those performed with and without renal ischemia.

Main Methods:

  • Non-structured literature review of hemostatic techniques in LPN.
  • Categorization of methods into LPN with ischemia (warm, cold, regional) and LPN without ischemia (energy sources, sealants).

Main Results:

  • Various energy sources have limitations like scarring and smoke.

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  • Fibrin and thrombin-based sealants are valuable adjuncts.
  • Suturing with bolster and clips is standard for larger tumors; sealants may suffice for small, exophytic ones.

    • Conclusions:

    • Hemostasis in LPN is achieved by adapting open surgical protocols.
    • Renal ischemia and bolster sutures remain essential for complex LPN.
    • Sealant products can provide satisfactory hemostasis for select small tumors.