Laparoscopic Partial Nephrectomy with a Novel Electrosurgical Snare in a Porcine Model

Collyer, William C.; Landman, Jaime; Olweny, Ephrem O.; Andreoni, Cássio; Kibel, Adam S.; Andriole, Gerald L.; Bostwick, David G.; Sundaram, Chandru P.; Clayman, Ralph V.

doi:10.1089/089277902761403032

Cited by 12 publications

(6 citation statements)

References 11 publications

(9 reference statements)

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“…1–9 Although LPN techniques that duplicate open nephron-sparing surgery have been reported, the need for intracorporeal suturing represents a limitation. 1 Various alternative surgical techniques, devices, and topical hemostatic agents have been proposed, yet none have emerged as the optimal treatment for LPN.…”

Section: Discussionmentioning

confidence: 99%

“…1 Various alternative surgical techniques, devices, and topical hemostatic agents have been proposed, yet none have emerged as the optimal treatment for LPN. 2–9 On-going concerns regarding topical hemostatic agents have centered around ease of use, preparation time, the potential for viral transmission, biological inertness, and cost.…”

Section: Discussionmentioning

confidence: 99%

“…1 Several hemostatic agents and technical adjuncts have been evaluated in an attempt to simplify LPN, yet an optimal alternative approach has not been realized. 2–9 …”

Section: Introductionmentioning

confidence: 99%

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1291: Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open and Laparoscopic Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

Murat¹,

Ereth²,

Dong³

et al. 2004

Journal of Urology

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Objectives:We evaluated the efficacy of Microporous Polysaccharide Hemospheres (MPH) for parenchymal hemostasis during laparoscopic partial nephrectomy (LPN) in the porcine model.Methods:Six female farm pigs underwent a transperitoneal right lower-pole LPN during occlusion of the renal hilum. Renal parenchyma was excised using cold Endoshears. MPH was applied to the defect and the hilar clamp released. Animals were kept alive for one week. Before sacrifice, left LPN was similarly performed using MPH. Study variables included blood loss, number of MPH applications, hilar clamp time, hemostasis time, perioperative complications, and abnormalities noted at sacrifice.Results:Hemostasis was achieved in all kidneys solely by using MPH. The average excised specimen represented 5.6% (range, 3.6 to 8.5) of renal weight. Mean hilar clamp and hemostatic times were 12.8 minutes (range, 6 to 18) and 2 minutes (range, 1 to 3), respectively. Hemostasis occurred after one MPH application in 8 kidneys (67%). In 3 kidneys, additional MPH powder was required to treat minor residual bleeding. In the remaining kidney, a second standard MPH application was required for hemostasis. No operative complications were encountered. No hematomas or residual MPH was found at necropsy; however, small urinomas were found in 2 of 6 kidneys.Conclusions:In the experimental porcine model, this initial study suggests that MPH provides effective parenchymal hemostasis during laparoscopic resection of an exophytic kidney lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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1291: Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open and Laparoscopic Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

Murat¹,

Ereth²,

Dong³

et al. 2004

Journal of Urology

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“…In the study from Washington University reporting the use of the electrosurgical snare in LPN without occlusion of hilar vessels (38), the hemostasis was successfully achieved in all but one case, where it was necessary to use the argon-beam coagulator to stop the bleeding after parenchymal resection.…”

Section: Electrical Snare: Cutting and Hemostatic Energymentioning

confidence: 97%

Energy sources for laparoscopic partial nephrectomy: critical appraisal

et al. 2007

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Laparoscopic partial nephrectomy (LPN) has emerged as a viable alternative for the conventional open nephron-sparing surgery (NSS). So far, an adequate renal parenchymal cutting and hemostasis, as well as caliceal repair remains technically challenging. Numerous investigators have developed techniques using different energy sources to simplify the technically demanding LPN. Herein we review these energy sources, discussing perceived advantages and disadvantages of each technique.

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“…In one case, additional haemostasis was required using the argon beam coagulator. 25 Retroperitoneoscopic nephron-sparing surgery using a microwave tissue coagulator has also been performed, for small renal tumours. Minimal blood loss occurred.…”

Section: Partial Nephrectomymentioning

confidence: 99%

Haemostasis in Urology

Undre

Patel

2007

Haemostasis in Surgery

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Laparoscopic Partial Nephrectomy with a Novel Electrosurgical Snare in a Porcine Model

Abstract: Laparoscopic partial nephrectomy with the arcing-gap electrosurgical snare is feasible in a porcine model. Application of the snare provides excellent hemostasis without the need to control the renal vasculature.

Cited by 12 publications

References 11 publications

1291: Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open and Laparoscopic Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

1291: Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open and Laparoscopic Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

Energy sources for laparoscopic partial nephrectomy: critical appraisal

Haemostasis in Urology

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