BioGlue surgical adhesive as a thermal reflector during laparoscopic cryoablation: effect on iceball size and ablation zone diameter.
OBJECTIVE
Cryoablation represents an alternative for treating small renal cortical neoplasms (RCN). Previously, we demonstrated that applying BioGlue during cryoablation diminished bleeding and incidentally noted that the iceballs seemed larger than those in  controls. We examined the effects of BioGlue as a thermal insulator of cryoablated tissue to determine its effect on iceball size.


METHODS
Laparoscopic cryoablation (LCA) was performed in 6 female pigs (24 ablations) by using a single 1.47-mm cryoablation probe. One pole of each  kidney was randomly treated with BioGlue prior to ablation, while the contralateral pole was the untreated control. The size of the iceball was measured using laparoscopic ultrasound. The tissue ablation zone was measured grossly after the specimens were harvested. We also documented the amount  of bleeding on a subjective scale.


RESULTS
There were no differences in the diameters of the iceballs between the BioGlue and control groups when measured with laparoscopic ultrasound (P=.85). Similarly, the ablation zones on gross measurement were not significantly different (P=.47).  No difference occurred in the amount of subjective bleeding.


CONCLUSIONS
In a porcine model, the application of BioGlue prior to LCA does not appear to increase the size of the iceball generated. No change was observed in the amount of subjective bleeding as a result of using BioGlue.
New York University School of Medicine, Department of Urology, New York, NY, USA.
Adam C
AC
Mues
Phillip
P
Mucksavage
Joseph A
JA
Graversen
Jaime
J
Landman
D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical; D010535:Laparoscopy; D011506:Proteins / Q000627:therapeutic use*; D013552:Swine; D013696:Temperature; D014014:Tissue Adhesives / Q000627:therapeutic use*
C472676:Bio-glue; D011506:Proteins; D014014:Tissue Adhesives