Maximum tensile force of different suture techniques in reconstruction of the renal remnant after nephron-sparing surgery

Simon, J.; Finter, F.; Ignatius, Anita; Meilinger, Michael; Dürselen, Lutz

doi:10.1007/s00464-010-1201-0

Cited by 10 publications

(12 citation statements)

References 16 publications

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“…Two different groups demonstrated that the absence of renal capsule at the moment of renorrhaphy severely weakens parenchyma strength, while the presence of it helps withstand pressure from the suture allowing for adequate hemostasis. 8,14 In essence, capsular indemnity is vital for quality suturing.…”

Section: Discussionmentioning

confidence: 99%

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Synthetic Renal Capsule Tailoring: A Novel Renorrhaphy Technique After Subcapsular Dissection of Renal Tumors with Severe Adherent Perirenal Fat During Laparoscopic Partial Nephrectomy

Vitagliano

Lopez

Guglielmi

et al. 2017

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Section: Discussionmentioning

confidence: 99%

“…To this respect, tensile strength has been compared between normal and decapsulated human kidneys. 8 Decapsulated kidneys resist between 43% and 63% less than normal ones deeming renorrhaphy a very challenging task with the inherent risk of severe surgical bleeding.…”

Section: Introductionmentioning

confidence: 99%

Synthetic Renal Capsule Tailoring: A Novel Renorrhaphy Technique After Subcapsular Dissection of Renal Tumors with Severe Adherent Perirenal Fat During Laparoscopic Partial Nephrectomy

Vitagliano

Lopez

Guglielmi

et al. 2017

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Several surgical methods exist for achieving hemostasis following tumor enucleation including: the traditional closure of the parenchymal defect with suture ligasure by application of topical absorbable hemostats such as oxidized regenerated cellulose, gelatin, collagen and liquid fibrin sealants have been employed to decrease intraoperative renal ischemic time, provide rapid hemostasis and improve visualization of the surgical field [5,[9][10][11][12]. In our series we have used BG to fill the parenchymal defect.…”

Section: Discussionmentioning

confidence: 99%

CT Appearance Following Partial Nephrectomy for Renal Cell Carcinoma Using Tissue Adhesive Bioglue

Croituro¹,

Braz²,

Moskovitz³

et al. 2013

OJU

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Background: The use of biological sealants has greatly increased during nephron sparing surgery. In many cases the bulk of the material was erroneously mistaken for tumor recurrence. Objective: To describe the characteristic appearance of biological adhesive material used for tumor bed closure on computerized tomography (CT) following nephrone sparing surgery (NSS) for renal cell carcinoma, in order to differentiate between typical features of the adhesive material and local tumor recurrence. Design, Setting and Participants: We retrospectively reviewed follow-up CT scans of 120 patients who underwent NSS for T1N0M0 RCC. In all cases tumor bed was closed during surgery with biological tissue adhesive (BioGlue). Results and Limitations: During 1994-2009, 120 patients with a single T1 renal cell carcinoma lesion, underwent NSS with closure of tumor bed with bio adhesive material. There were 66 males and 47 females with mean age of 58.7 years (median: 58 years, range: 28 - 85 years). Mean follow-up time was 45 ± 34 months (median 42, range 12 - 168). During follow-up, 3 patients had local recurrence at the site of previous enucleated lesion. In the first post-operative CT scan the BG appeared as a heterogeneous mass with sharp edges measuring 20 - 70 HU with no attenuation following the injection of contrast material. In subsequent follow-up scans the BG in most patients remained stable in size; in few patients slight reduction in size was observed probably due to the resolution of post-operative hematoma. Tumor recurrence that was documented in 3 patients was seen as a heterogeneous mass with attenuation of more than 20 HU following the injection of contrast material. In sequential CT’s the mass was increasing in size. Conclusions: BG appears as a non-enhancing stable mass in sequential CT’s following NSS, hence could be differentiated from local tumor recurrence. Th...

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“…In contrast to conventional surgical techniques for hemostasis, the use of a Surgisis ® membrane does not compromise blood flow in the parenchymal resection margin, since no parenchymal tissue has to be gathered or folded. The running suture technique mimicking the fixation of a drumhead (Figure 2) additionally enables maximal stability and prevents tearing of the suture from the renal capsule [26]. Another great advantage of this technique is the establishment of a phantom or placeholder volume beneath the membrane (Figure 1) which enables the establishment of homogenous pressure on the resection area.…”

Section: Discussionmentioning

confidence: 99%

Partial nephrectomy using porcine small intestinal submucosa

et al. 2011

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BackgroundWhenever technically feasible and oncologically justified, nephron-sparing surgery is the current standard of care for localized renal cell carcinomas (RCC). The main complications of partial nephrectomy, especially for large and centrally located tumors, are urinary leakage and parenchymal bleeding. We prospectively evaluated the pros and cons of using porcine small intestinal submucosa (SIS, Surgisis®) to close the renal defect after nephron-sparing surgery.MethodsWe used Surgisis® (Cook medical, Bloomington, IN, USA) to secure and compress the capsular defect after tumor resection in 123 patients submitted to 129 partial nephrectomies between August 2003 and February 2011.ResultsThe median tumor size was 3.7 cm (range 1.1-13.0 cm). Procedures were performed with cold ischemia in 24 cases (18.2%), with warm ischemia in 46 (35.6%), and without ischemia in 59 cases (44.8%). In the total group of patients, 4 (3.1%) developed urinary fistula, and only 2 (1.6%) required postoperative transfusions due to hemorrhage after the application of the small intestinal submucosa membrane.ConclusionSmall intestinal submucosa is an easy-to-use biomaterial for preventing complications such as postoperative bleeding and urinary fistula in nephron-sparing surgery, especially in cases where tumor excision causes significant renal capsular and/or renal pelvic defects.

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Maximum tensile force of different suture techniques in reconstruction of the renal remnant after nephron-sparing surgery

Cited by 10 publications

References 16 publications

Synthetic Renal Capsule Tailoring: A Novel Renorrhaphy Technique After Subcapsular Dissection of Renal Tumors with Severe Adherent Perirenal Fat During Laparoscopic Partial Nephrectomy

Synthetic Renal Capsule Tailoring: A Novel Renorrhaphy Technique After Subcapsular Dissection of Renal Tumors with Severe Adherent Perirenal Fat During Laparoscopic Partial Nephrectomy

CT Appearance Following Partial Nephrectomy for Renal Cell Carcinoma Using Tissue Adhesive Bioglue

Partial nephrectomy using porcine small intestinal submucosa

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