Introducing a new sealant applicator for easy, safe, and quick closure of a mini-percutaneous nephrolitholapaxy access tract

J Endourol. 2007 Apr;21(4):393-6. doi: 10.1089/end.2006.0244.

Abstract

Purpose: 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).

Patients and 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.

Conclusion: 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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Hemostatics / pharmacology*
  • Humans
  • Kidney / diagnostic imaging
  • Male
  • Middle Aged
  • Nephrostomy, Percutaneous / methods*
  • Postoperative Care
  • Tomography, X-Ray Computed

Substances

  • Hemostatics