Hemopatch® as a Hemostatic Agent is Safe in Partial Nephrectomy: A Large, Single-Surgeon Retrospective Evaluation

Abstract

Introduction Partial nephrectomy (PN) has evolved into the surgical standard of care for localized renal lesions. Hemostatic agents (HA) support the surgeon in achieving local hemostasis during PN. We previously reported initial results with the HA Hemopatch ® in PN. We now report our experiences with Hemopatch ® in a larger and more challenging single-surgeon PN cohort. Methods Our study included 45 patients who underwent PN due to suspicious renal lesions between December 2013 and March 2018. All surgeries were performed by a single surgeon using the HA Hemopatch ® . Preoperative, intraoperative, and postoperative parameters were assessed. Results Preoperative median tumor diameter was 27 mm. Median PADUA and RENAL nephrometry scores were 7 and 6, respectively. In 13.3% of the cases an additional HA was applied. Intraoperative and postoperative bleeding occurred in 2.2% and 8.9%, respectively. Median total blood loss was 200 ml. Urgent pedicle clamping due to bleeding was necessary in 2 (4.4%) patients. The transfusion rate was 8.9%. There were no conversions. Conclusion We confirmed our initial results demonstrating feasibility and reliability of Hemopatch ® during PN. Notably, the cohort consists of selected patients. Prospective randomized studies are needed for comparison of different types of HA with regard to perioperative outcome.

The use of sealing hemostat patch (HEMOPATCH®) in laparotomic myomectomy: a prospective case–control study

“…HEMOPATCH is a sealing hemostat patch that has been used widely in different surgical elds such as Neurosurgery as dural sealant in cranial and spinal procedures, in pancreatic surgery in order to prevent postoperative pancreatic stula after distal pancreasectomy or in Urology to support the surgeon in achieving local hemostasis during partial nephrectomy or in cardiac surgery [25][26][27][28]. Its application in gynecology has not been evaluated by prospective studies, so we cannot have direct comparisons, except for the use of other topical hemostats, such as Floseal in Ovarian cystectomy, Tisseel and Floseal in laparoscopic myomectomy, and retrospective studies on hysterectomy for pathology benign [30,31].…”

PEG-coated patch parenchymal closure technique and initial outcomes during minimally invasive partial nephrectomy

“…There are similarities and differences between this series and the previously reported series of PEG-coated patch use in partial nephrectomy. 10 Surgical approach, technique with a hemostatic running suture in the defect base, and RENAL scores were similar. We did not use additional hemostatic agents and did not report any blood transfusion or intervention for bleeding.…”

“…McLarty et al Techniques: PEG-coated patch for MIPN 4 © 2021 Canadian Urological Association 45 patients over a five year period. 10 In this update, they confirmed a PEG-coated patch can be applied to more complex partial nephrectomy patients but reported a 6% rate of intervention for post-operative bleeding.…”

Hemopatch® is effective and safe to use: real-world data from a prospective European registry study

“…Hupe et al reported only a few bleeding events in patients undergoing partial nephrectomy using Hemopatch ® . Most of these procedures were performed as MIS [ 11 ]. Furthermore, Hemopatch® proved to be feasible and reliable in laparoscopic partial nephrectomy [ 7 ] and laparoscopic cholecystectomy [ 13 ].…”

“…Several case series and smaller studies describe the effective and reliable use of Hemopatch ® in a variety of clinical applications, including solid organ, neurological, gastrointestinal, biliopancreatic, endocrine, urologic and cardiovascular procedures [6][7][8][9][10][11][12][13][14][15][16][17][18].…”