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Updated: Jun 28, 2026
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Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Suture or hemostatic agent during laparoscopic partial nephrectomy? A randomized study using a hypertensive porcine
Yannick Rouach1, Nicolas Barry Delongchamps, Natacha Patey
1Department of Urology, Necker Hospital, Paris, France.
Urology
|October 28, 2008
Summary
Thrombin/gelatin granules effectively controlled bleeding and reduced warm ischemia time during laparoscopic partial nephrectomy in pigs. However, conventional suture remains important for urinary tract closure.
Area of Science:
- Urology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Laparoscopic partial nephrectomy (LPN) requires effective hemostasis and urinary tract closure.
- Minimizing warm ischemia (WI) time is crucial for preserving renal function.
- Hypertensive porcine models offer a relevant platform for evaluating surgical techniques.
Purpose of the Study:
- To compare the efficacy of three biologic hemostatic devices against conventional suture in LPN.
- To assess hemostasis, urinary tract closure, and WI time in a porcine model.
Main Methods:
- 40 pigs underwent bilateral LPN, with varying parenchyma resection and urinary tract involvement.
- Renal sections were treated with fibrin/thrombin sealant, fibrin glue, thrombin/gelatin granules, or conventional suture.
- Outcomes measured included blood loss, WI time, leak pressure, and parenchymal necrosis.
Main Results:
- Thrombin/gelatin granules and suture showed significantly lower blood loss.
- Thrombin/gelatin granules significantly decreased WI time compared to suture.
- Suture provided greater urinary tract leak pressure, while non-sutured closures resulted in less necrosis.
Conclusions:
- Thrombin/gelatin granules offer comparable hemostasis to suture and reduce WI time.
- Conventional suture is recommended for urinary tract closure when opened.
- Further human studies are needed to guide clinical recommendations.
