Introducing a new sealant applicator for easy, safe, and quick closure of a mini-percutaneous nephrolitholapaxy access tract.
OBJECTIVE
To achieve better hemostasis after mini-percutaneous nephrolitholapaxy (mini-PCNL), we developed a new application device that can be used to close the renal-access tract with gelatin matrix hemostatic sealant (GMHS).


METHODS
After mini-PCNL was performed on 11 patients, a Double-J ureteral stent was placed antegrade. After retraction of the 18F Amplatz sheath out of the collecting system under vision without irrigation, the urothelium collapsed. The 15F metal applicator with a 10F working channel was then inserted and GMHS injected during further retraction of both the device and the Amplatz sheath. The skin was closed with Steri-strips.


RESULTS
The renal parenchymal tract of the mini-PCNL can be sealed in 15 to 50 seconds. Postoperatively, no urinoma was observed. All patients had an uneventful follow-up.


CONCLUSIONS
Closing the track of the mini-PCNL with the new application device and GMHS is a safe, easy, and quick alternative to the common nephrostomy tube.
Nagele
Udo
U
Department of Urology, University of Tübingen, Tübingen, Germany.
Anastasiadis
Aristotelis G
AG
Schilling
David Alexander
DA
Sievert
Karl Dietrich
KD
Kuczyk
Markus A
MA
Stenzl
Arnulf
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006490:Hemostatics / Q000494:pharmacology*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011182:Postoperative Care; D014057:Tomography, X-Ray Computed
D006490:Hemostatics