Objectives: Haemostasis remains the greatest challenge during laparoscopicpartial nephrectomy. Use of fibrin sealant currently is increasing.We describe first a technique for achieving effective haemostasis duringlaparoscopic partial nephrectomy using the VivostatTM system.Methods: Ten patients underwent laparoscopic partial nephrectomy.Autologous fibrin sealant was prepared with the VivostatTM systemand applied to the resection bed. This system is an automated medicaldevice for the preparation of an autologous fibrin sealant, generating upto 5 ml of sealant from 120 ml of the patient’s blood. The concentration offibrin and the volume of sealant are stable; the sealant may be kept atroom temperature for up to 8 hours before application without a loss ofproperties and effectiveness.The patients were evaluated for acute and delayed bleeding.Results: Mean patient’s age was 54 years (range, 31–68). Haemostasis wasimmediate in all cases after application of the sealant for 1 to 2 minutesto the resection site; no additional haemostatic measures were required.Mean warm ischemia time was 23 minutes (range, 20–27); mean bloodloss was 90 cc (range, 20–200). Pre-operative and post-operative serumhaemoglobin did not differ significantly (mean, 14.9 vs 12.6 g/dl) andcreatinine values (mean, 0.91 vs 0.95 ng/ml). Mean operative time was136 minutes (range, 60–180). No postoperative bleeding or other complicationsoccurred.Conclusions: In this study, immediate haemostasis was achieved andmaintained after the kidney was reperfused. Our initial experience withthe VivostatTM system in laparoscopic partial nephrectomy has beenencouraging.
Autologous fibrin glue using the Vivostat system for hemostasis in laparoscopic partial nephrectomy
Schips L;
2006-01-01
Abstract
Objectives: Haemostasis remains the greatest challenge during laparoscopicpartial nephrectomy. Use of fibrin sealant currently is increasing.We describe first a technique for achieving effective haemostasis duringlaparoscopic partial nephrectomy using the VivostatTM system.Methods: Ten patients underwent laparoscopic partial nephrectomy.Autologous fibrin sealant was prepared with the VivostatTM systemand applied to the resection bed. This system is an automated medicaldevice for the preparation of an autologous fibrin sealant, generating upto 5 ml of sealant from 120 ml of the patient’s blood. The concentration offibrin and the volume of sealant are stable; the sealant may be kept atroom temperature for up to 8 hours before application without a loss ofproperties and effectiveness.The patients were evaluated for acute and delayed bleeding.Results: Mean patient’s age was 54 years (range, 31–68). Haemostasis wasimmediate in all cases after application of the sealant for 1 to 2 minutesto the resection site; no additional haemostatic measures were required.Mean warm ischemia time was 23 minutes (range, 20–27); mean bloodloss was 90 cc (range, 20–200). Pre-operative and post-operative serumhaemoglobin did not differ significantly (mean, 14.9 vs 12.6 g/dl) andcreatinine values (mean, 0.91 vs 0.95 ng/ml). Mean operative time was136 minutes (range, 60–180). No postoperative bleeding or other complicationsoccurred.Conclusions: In this study, immediate haemostasis was achieved andmaintained after the kidney was reperfused. Our initial experience withthe VivostatTM system in laparoscopic partial nephrectomy has beenencouraging.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
