"Partial Nephrectomy with Veriset: A Renorrhaphy-Less Approach"

Introduction and Objectives: Renorrhaphy during partial nephrectomy is technically challenging and can extend the warm ischemia time (WIT). This study investigates the use of Veriset™ as an alternative to renorrhaphy in robot-assisted partial nephrectomy (RAPN) and presents our findings. Methods: In this retrospective analysis, 43 patients who had Veriset patch placed on the tumor bed post resection were compared against 43 patients who underwent conventional single-layer renorrhaphy for RAPN from January 2023 to January 2024 at our institution. The two groups underwent propensity score matching based on age, body mass index, and R.E.N.A.L. nephrometry score. Data of all patients, including patient demographic details, tumor characteristics including size, location, pre- and postoperative blood investigations, intraoperative findings, blood loss, postoperative course, complications, and follow-up of 6 months duration, were recorded. Results: The mean age of the study population was 52.62 ± 13.31 years, and the mean nephrometry score was 6.64 ± 1.91. The Veriset patch application failed in three patients (6.97%) and cortical renorrhaphy had to be performed for hemostasis. The Veriset group (VG) had significantly less console time and WIT when compared with renorrhaphy group (RG) (82.02 ± 25.17 minutes and 11.95 ± 10.02 minutes, respectively, vs 95.53 ± 29.80 minutes and 17.63 ± 6.59 minutes; p = 0.014 and p < 0.001, respectively). The RG witnessed a significant reduction in estimated glomerular filtration rate (eGFR) on postoperative day 1 as opposed to VG (-7.56 ± 15.89 mL/min/1.73 m² vs -0.21 ± 11.12 mL/min/1.73 m²; p = 0.015). The intraoperative blood loss, need for blood transfusion, postoperative change in hemoglobin rates, readmission, and renal function at 6 months in the VG and RG were comparable. Conclusions: The Veriset application instead of renorrhaphy led to reduced WIT, decreased console time, and early return of renal function with no significantly increased rate of complications.