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Updated: Jul 10, 2026
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Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Use of a chitosan-based hemostatic dressing in laparoscopic partial nephrectomy
Hua Xie1, Yashodhan S Khajanchee, Jeffrey S Teach
1Oregon Medical Laser Center, Providence St. Vincent Medical Center, Portland, Oregon, USA. hua.xie@providence.org
Summary
A novel chitosan dressing effectively controlled bleeding and sealed wounds after laparoscopic partial nephrectomy in a porcine model. This internal hemostatic dressing shows promise for managing hemorrhage and urinary leakage in kidney surgery.
Area of Science:
- Urology
- Surgical Innovation
- Biomaterials
Background:
- External chitosan bandages are used for traumatic bleeding.
- Laparoscopic partial nephrectomy (LPN) presents challenges in controlling parenchymal hemorrhage and urinary leakage.
Purpose of the Study:
- To assess the feasibility of an internal chitosan dressing for managing bleeding and urinary leakage after LPN.
- To evaluate the hemostatic and sealing capabilities of the chitosan dressing in a porcine model.
Main Methods:
- Nine heparinized swine underwent bilateral LPN (polar or wedge resections).
- A chitosan dressing was applied to control hemorrhage and seal the surgical site.
- Blood loss, hemostasis score, urinary leakage, operative time, and adhesion were recorded.
Main Results:
- Complete hemostasis was achieved in 17 out of 18 procedures.
- Significant improvement in hemostasis scores was observed post-dressing application (p < 0.001 for polar, p = 0.017 for wedge).
- Successful pyelocaliceal sealing rates were 85% for polar and 60% for wedge resections.
Conclusions:
- The chitosan-based hemostatic dressing is effective for controlling parenchymal hemorrhage after LPN.
- The dressing successfully seals the renal collecting system, managing urinary leakage.
- This internal dressing serves as a viable primary or supplemental option in LPN.
