Renal parenchymal hemostatic aids: glues and things.
OBJECTIVE
Open partial nephrectomy is now recognized as the standard of care for small renal parenchymal tumors. Significant technical problems remain with regard to performing this procedure laparoscopically, namely warm renal ischemia during occlusion of the renal vascular pedicle and renal parenchymal bleeding following tumor excision and release of pedicle control. This article reviews the recent literature in the field of renal parenchymal hemostasis and its role in improving outcomes and increasing applicability for laparoscopic nephron-sparing surgery.


RESULTS
Two themes emerge in reviewing the recent literature on renal hemostasis: the use of increasingly advanced tissue sealants and the use of physical methods. Advances in both areas are covered in this article.


CONCLUSIONS
Laparoscopic partial nephrectomy has been developed in an attempt to reduce the morbidity of the open technique. We believe that advances in secure renal parenchymal hemostasis will increase the applicability of the laparoscopic procedure and bring it within the grasp of ordinary urologists.
Thompson
Trevor
T
Scottish Lithotriptor Center, Western General Hospital, Edinburgh, UK.
Ng
Chi-Fai
CF
Tolley
David
D
D020341:Absorbable Implants; D001672:Biocompatible Materials / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009392:Nephrectomy / Q000379:methods*; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*
D001672:Biocompatible Materials; D014014:Tissue Adhesives