Evaluation of Hemostatic Aids in Laparoscopic Nephron-Sparing Surgery

Abstract

Partial nephrectomy is considered the standard of care for the management of small renal masses, and laparoscopic techniques are becoming popular for multiple reasons, one of which is minimal invasiveness. On the other hand, kidneys are extremely vascular organs, and renal hemorrhage is a major cause of morbidity after laparoscopic partial nephrectomies. Control of bleeding and management of calyceal injuries can be difficult and make the procedure technically challenging. This review looks at the various energy sources and hemostatic agents that are available to reduce bleeding during laparoscopic partial nephrectomies.

Canadian Update on Surgical Procedures (CUSP) Urology Group consensus for intraoperative hemostasis during minimally invasive partial nephrectomy

“…In real world application, in the absence of randomized evidence stating superiority, this may depend on the operator's experience. Ultimately, within this area, there continues to be limited evidence towards their efficacy outside of animal models, single centre or single surgeon small retrospective case series, or only with selective agents/techniques [15][16][17][18][19][20][21][22][23] , and this study is the first to provide an approach on the utilization of these agents through the experience of expert urologic surgeons (CUSP).…”