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Functional Duration of Closure Systems Used in Partial Nephrectomy.

Ruchir Gupta1, Nadia Sunny2, Sabrina L Noyes3

  • 1Forest Hills Central High School, Grand Rapids, Michigan.

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|July 16, 2016
PubMed
Summary

Knot/Hem-o-Lok closure systems demonstrated superior functional life compared to Lapra-Ty/Hem-o-Lok and Hem-o-Lok/Hem-o-Lok during partial nephrectomy simulations. Vicryl and V-Loc sutures are recommended for reliable closure.

Keywords:
equipment failure analysiskidneynephrectomypostoperative complicationssutures

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Area of Science:

  • Urology
  • Surgical Innovation
  • Biomaterials Science

Background:

  • Partial nephrectomy is a crucial procedure for kidney preservation.
  • Effective closure systems are vital for successful surgical outcomes.
  • Evaluating the functional life of different closure configurations is essential for optimizing surgical techniques.

Purpose of the Study:

  • To determine the functional life of various partial nephrectomy closure systems.
  • To compare the performance of knot/Hem-o-Lok, Lapra-Ty/Hem-o-Lok, and Hem-o-Lok/Hem-o-Lok configurations.
  • To assess suture material failure under simulated physiological conditions.

Main Methods:

  • Sutured renorrhaphy models were created using Vicryl, Stratafix (polyglycolic acid-polycaprolactone), and V-Loc sutures.
  • Tested closure systems included knot/Hem-o-Lok, Lapra-Ty/Hem-o-Lok, and Hem-o-Lok/Hem-o-Lok combinations.
  • Sutures were subjected to 4 N or 2 N of tension in a 37°C saline environment, with failure defined as breakage or slippage.

Main Results:

  • At 4 N, knot/Hem-o-Lok showed significantly lower failure rates (20%) compared to Lapra-Ty/Hem-o-Lok (56%) and Hem-o-Lok/Hem-o-Lok (100%) at 3 weeks.
  • Slippage was the primary failure mode for Lapra-Ty/Hem-o-Lok and Hem-o-Lok/Hem-o-Lok, whereas knot/Hem-o-Lok failures were less frequent.
  • Vicryl and V-Loc sutures demonstrated the best performance, with knot/Hem-o-Lok and Lapra-Ty/Hem-o-Lok showing no failures at 4 N with specific configurations.

Conclusions:

  • Knot/Hem-o-Lok closure systems provide superior functional durability compared to Lapra-Ty/Hem-o-Lok and Hem-o-Lok/Hem-o-Lok configurations.
  • Knots are more effective than Lapra-Tys in securing Hem-o-Loks at 4 N tension.
  • For reliable closure at 4 N, Vicryl zero or V-Loc 2-zero/3-zero sutures combined with knots or Lapra-Tys are recommended.