Current applications of fibrin sealant in urologic surgery

Abstract

Biosurgical preparations designed to promote surgical hemostasis and tissue adhesion are being increasingly employed across all surgical disciplines. Fibrin sealant is the most widely studied and utilized biosurgical adjunct in urology. Complex reconstructive, oncologic, and laparoscopic genitourinary procedures are those most appropriate for sealant use. This article details the diverse urologic applications of fibrin sealant in the management of genitourinary injuries, surgery, and complications.

The use of fibrin sealant to prevent major complications following laparoscopic gastric bypass: results of a multicenter, randomized trial

“…Off-label indications include hemostasis following trauma, closure of various gastric or rectovaginal fistulae, coverage of the bile duct, tracheal anastomoses and bronchial stump reinforcement [7][8][9]. Also, the widespread use of fibrin sealants has been reported in urology [8] and in many laparoscopic procedures [5,9,[10][11][12][13][14][15][16][17]. In Europe, several types of fibrin sealants are currently available (Tissucol Ò /Tisseel Ò [Baxter AG, Vienna, Austria], Quixil TM [Omrix], Beriplast Ò [Behring]) [1,2,5,7,9].…”

“…The differences between the various sealants are largely dependent on the quality and quantity of the two basic components, as well as the nature of the fibrinolysis inhibitor [2,7,18]. For this study, Tissucol Ò /Tisseel Ò fibrin sealant was chosen due to its favorable safety profile (no side effects, no transmitted infectious diseases and no embolization or coagulopathy reported [2,7,8,19,20]), wide-scale use, long clinical history, reported use in laparoscopic procedures [21][22][23] and easy-to-use laparoscopic delivery devices.…”

Application of fibrin sealant at the urethrovesical anastomosis in robotic assisted radical prostatectomy: does it enable earlier Foley catheter and Jackson–Pratt drain removal?

“…In urology, Wbrin sealants are the most commonly employed, and though many applications are oV-label uses, there has been mounting evidence for their usefulness in urology [6][7][8][9][10][11]. Diner et al [11] report that use in radical retropubic prostatectomy decreases perioperative drain output, and suggest that in some patients undergoing traditional open radical prostatectomy application of Wbrin sealant could accelerate discharge.…”

“…[4,5] Fibrin sealants have been used for urologic application including partial nephrectomy (laparoscopic and open surgical procedures), which takes advantage of the hemostatic properties [5][6][7], and during hypospadias surgery, Wstula repair, and urethroplasty, which employ the sealant properties. [6,8,9] More recently, use of Wbrin sealant at the urethrovesical anastomosis in radical retropubic prostatectomy has been employed to facilitate earlier catheter removal [10] and decreased urinary leakage [11]. No studies have been done to date expanding this use into robotic surgery but, by inference, application of Wbrin sealant at the urethrovesical anastomosis during RALRP may oVer advantages.…”

Use of fibrin glue as a sealant at the anastomotic line in laparoscopic pyeloplasty: A randomised controlled trial

“…It is used for three major reasons in urological surgery: as a urinary tract sealant in urological anastomosis like pyeloplasty, haemostatic agent, and as a tissue adhesive [9].…”