title: Evaluation of microporous polysaccharide hemospheres for parenchymal hemostasis during laparoscopic partial nephrectomy in the porcine model.
abstract: OBJECTIVE
  We evaluated the efficacy of Microporous Polysaccharide Hemospheres (MPH) for parenchymal hemostasis during laparoscopic partial nephrectomy (LPN) in the porcine model.
  
  
  METHODS
  Six female farm pigs underwent a transperitoneal right lower-pole LPN during occlusion of the renal hilum. Renal parenchyma was excised using cold Endoshears. MPH was applied to the defect and the hilar clamp released. Animals were kept alive for one week. Before sacrifice, left LPN was similarly performed using MPH. Study variables included blood loss, number of MPH applications, hilar clamp time, hemostasis time, perioperative complications, and abnormalities noted at sacrifice.
  
  
  RESULTS
  Hemostasis was achieved in all kidneys solely by using MPH. The average excised specimen represented 5.6% (range, 3.6 to 8.5) of renal weight. Mean hilar clamp and hemostatic times were 12.8 minutes (range, 6 to 18) and 2 minutes (range, 1 to 3), respectively. Hemostasis occurred after one MPH application in 8 kidneys (67%). In 3 kidneys, additional MPH powder was required to treat minor residual bleeding. In the remaining kidney, a second standard MPH application was required for hemostasis. No operative complications were encountered. No hematomas or residual MPH was found at necropsy; however, small urinomas were found in 2 of 6 kidneys.
  
  
  CONCLUSIONS
  In the experimental porcine model, this initial study suggests that MPH provides effective parenchymal hemostasis during laparoscopic resection of an exophytic kidney lesion.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Francois-Joseph L
authors.initials: FJ
authors.lastname: Murat
authors.forename: Carter Q
authors.initials: CQ
authors.lastname: Le
authors.forename: Mark H
authors.initials: MH
authors.lastname: Ereth
authors.forename: Mark P
authors.initials: MP
authors.lastname: Piedra
authors.forename: Yue
authors.initials: Y
authors.lastname: Dong
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
mesh_terms: D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D009392:Nephrectomy / Q000379:methods; D019990:Perioperative Care / Q000379:methods; D011134:Polysaccharides / Q000008:administration & dosage*; D011208:Powders; D013552:Swine; D013997:Time Factors
chemical_list: D011134:Polysaccharides; D011208:Powders