Use of Gelatin Matrix Thrombin Tissue Sealant as an Effective Hemostatic Agent During Laparoscopic Partial Nephrectomy

Abstract

The 2-component tissue sealant provided immediate and durable hemostasis in laparoscopic partial nephrectomy. It is a safe and time sparing alternative adjunct to currently available means of achieving hemostasis. In a select patient population use of this agent may reduce warm ischemia time by circumventing the need to perform laparoscopic suturing.

Use of Gelatin-Thrombin Matrix Hemostatic Sealant in Cranial Neurosurgery

“…1) This effect is supported by the moderate swelling (about 10-20%) of the gelatin-thrombin matrix following contact with blood or other body fluids. 1) This gelatin-thrombin matrix is useful in cardiac, 24,25) spinal, 29) maxillofacial and plastic facial, 11,12,28) rhinologic, 2,4) and urologic 31,34) surgery. However, little is known about its use in brain surgery except in transsphenoidal pituitary surgery, in which the safety and biocompatibility were comparable with hemostatic agents currently in use.…”

“…Evaluation of the biocompatibility of gelatinthrombin matrix in a rabbit model of splenic injury and bleeding 1) found no gross evidence of the material after 14 days, and no postoperative adhesions. The observed acute inflammatory response and fibrosis was typical of the normal wound healing process of the spleen following injury.…”

Bleeding during laparoscopic partial nephrectomy: Can a hemostatic matrix help to improve hemostasis?

“…Dalpiaz et al (19) reviewed the use of hemostatic agents in 15 animal model studies and 11 clinical trials concluding that fibrin sealants were effective in both animal and clinical studies. Richter et al and Bak et al (20,21) investigated the use of FloSeal in LPN in two different studies. In both studies no renal suturing was used, none of the patients underwent pelvicaliceal repair and none of the patients required blood transfusions.…”

Laparoscopic Partial Nephrectomy – Current State of the Art

“…FloSeal significantly reduced overall complications (37% vs. 16%) and had a trend towards lower rates of hemorrhagic complications (12% vs. 3%). Wille et al [84], Richter et al [85] and Bak et al [86] have also described positive series.…”