Simplified hemostatic technique during laparoscopic partial nephrectomy

Abstract

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Suture techniques during laparoscopic and robot‐assisted partial nephrectomy: a systematic review and quantitative synthesis of peri‐operative outcomes

“…A similar knotless technique was described by other groups , while some authors outlined the feasibility of omitting bolsters after a single‐ or double‐layer renorrhaphy . Such a bolsterless renorrhaphy technique was reported in selected cases of LPN for central lesions , as well as for exophytic tumours not contacting the UCS (UCS), for which haemostasis was performed in a sutureless fashion .…”

Laparoscopic partial nephrectomy for tumors 7cm and above. Perioperative outcomes

“…The defect is then closed in two layers. A running suture secured on both ends with an absorbable clip controls the resection bed (regardless of whether the collecting system is violated) and for the superficial layer a running suture interrupted by absorbable clips on one side of the defect is used ( 11 ). With the evolution of our technique we do not routinely use bolsters or other additional hemostatic agents aside from sutures.…”

Bolster material granuloma masquerading as recurrent renal cell carcinoma following partial nephrectomy

“…A review article has described use of bolsters as a gold standard for closing defects post partial nephrectomy, however, search of literature shows no study showing superiority of using bolsters over using no bolsters. [ 7 8 ] Contrary to this practice, there are a number of studies to suggest that defect in partial nephrectomies can be closed without use of bolsters. [ 8 9 10 ] Hemostatic agents have been shown to form a radiological artifact in many situations such as post liver, brain, ovarian, and kidney surgeries.…”

“…[ 7 8 ] Contrary to this practice, there are a number of studies to suggest that defect in partial nephrectomies can be closed without use of bolsters. [ 8 9 10 ] Hemostatic agents have been shown to form a radiological artifact in many situations such as post liver, brain, ovarian, and kidney surgeries. The absorption of blood products on oxidized cellulose may be responsible for the enhancement that is seen on CT scan.…”