Laparoscopic partial nephrectomy using FloSeal for hemostasis: technique and experiences in 102 patients

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Small renal masses are increasingly detected, necessitating effective and minimally invasive treatment options.
• Partial nephrectomy is the gold standard for preserving renal function while managing localized renal tumors.
• Laparoscopic partial nephrectomy (LPN) offers advantages over open surgery, including reduced morbidity and faster recovery.

Purpose of the Study:

• To evaluate the techniques, perioperative data, and oncological outcomes of LPN for exophytic renal tumors.
• To assess the feasibility and safety of using FloSeal for hemostasis during LPN.
• To determine the reproducibility of the LPN technique across multiple surgeons.

Main Methods:

• A retrospective review of 102 consecutive patients undergoing transperitoneal LPN for exophytic tumors.
• FloSeal was used for hemostasis; bulldog clamps and harmonic scalpel/scissors were employed for tumor resection.
• Frozen sections were obtained for margin assessment, with collection system defects repaired as needed.

Main Results:

• All 102 procedures were completed successfully without intraoperative complications.
• The mean operative time was 201 minutes, with a mean clamping time of 25.8 minutes in 64 cases.
• Negative margins were achieved in 92% of cases, with no observed recurrence at a mean follow-up of 32 months.

Conclusions:

• Laparoscopic partial nephrectomy utilizing FloSeal is a feasible and safe approach for treating small renal masses.
• The technique is reproducible for surgeons proficient in advanced laparoscopic procedures.
• Patient outcomes align with those reported for traditional open partial nephrectomy procedures.