Reducing laparoscopic radical prostatectomy false-positive margin rates using cyanoacrylate tissue glue

Area of Science:

• Urology
• Surgical Pathology
• Biomaterials

Background:

• Laparoscopic instruments can cause prostate surface trauma during radical prostatectomy (LRP).
• This trauma may lead to false-positive surgical margins in pathology reports.

Purpose of the Study:

• To assess the feasibility of using cyanoacrylate glue for repairing iatrogenic lacerations in prostate tissue.
• To evaluate the impact of glue repair on positive surgical margin rates in LRP specimens.

Main Methods:

• Porcine kidneys were used as a surrogate model to test glue repair quality on experimentally created lacerations.
• Lacerated kidney specimens were repaired with cyanoacrylate glue or left unrepaired (control).
• Both groups underwent histopathologic processing to assess "positive margins" indicated by surface marker ink staining.

Main Results:

• Cyanoacrylate glue effectively repaired renal lacerations, preventing marker dye from staining subcapsular tissues.
• The glue did not interfere with histopathologic assessment.
• Laparoscopic radical prostatectomy specimens repaired with glue showed a significantly lower positive margin rate (10%) compared to unrepaired specimens (35%).

Conclusions:

• Cyanoacrylate glue is a safe, effective, and inexpensive agent for repairing iatrogenic prostate lacerations.
• Repairing these lacerations with glue can substantially decrease the rate of false-positive surgical margins.
• This technique offers a practical solution to improve the accuracy of margin assessment in LRP specimens.