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Related Experiment Videos

Assessment of alternative tissue approximation techniques for laparoscopy

C G Eden1, M J Coptcoat

  • 1Department of Urology, King's College Hospital, London, UK.

British Journal of Urology
|August 1, 1996
PubMed
Summary

Fibrin glue offers an effective alternative to sutures for experimental urothelial re-anastomosis, demonstrating superior strength and faster application in laparoscopic procedures. This method shows promise for clinical use in reconstructive urology.

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Area of Science:

  • Urology
  • Surgical Innovation
  • Biomaterials

Background:

  • Traditional ureteral anastomosis relies on sutures, which can be time-consuming and may lead to complications.
  • Exploring alternative tissue approximation techniques is crucial for improving surgical outcomes in reconstructive urology.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of alternative tissue approximation methods for experimental urothelial re-anastomosis.
  • To compare fibrin glue and laser tissue welding against traditional suturing in open and laparoscopic settings.

Main Methods:

  • Phase 1: Open porcine ureteric re-anastomosis using gelatin/resorcin/formaldehyde (GRF) glue, fibrin glue, or laser tissue welding.
  • Phase 2: Comparison of the best technique from Phase 1 against sutured controls in porcine retroperitoneoscopic pyeloplasty.

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  • Assessment included leak pressure, operating time, urodynamic studies, and microscopy.

    • Main Results:

    • GRF glue was abandoned due to insufficient flexibility.
    • Fibrin glue demonstrated comparable leak pressures to laser welding and superior results in operating time and microscopic appearance.
    • In Phase 2, fibrin glue showed similar functional outcomes to sutures but with higher leak pressures, shorter operating times, and better histological results.

    Conclusions:

    • Fibrin glue is an effective alternative for experimental laparoscopic pelvi-ureteric anastomoses, offering reduced operating time and improved histological outcomes compared to sutures.
    • The technique withstood supra-physiological pressures without functional obstruction, justifying further clinical evaluation.