Use Of Titanium Staples During Upper Tract Laparoscopic Reconstructive Surgery: Initial Experience
- 1 October 2002
- journal article
- Published by Wolters Kluwer Health in Journal of Urology
- Vol. 168 (4 Part 1), 1366-1369
- https://doi.org/10.1016/s0022-5347(05)64450-3
Abstract
Using nonabsorbable titanium staples in the lower urinary tract during laparoscopic nephroureterectomy has been shown to be safe. Laboratory studies of titanium staples in the upper urinary tract have likewise been favorable. Therefore, we used titanium Endo-GIA tissue staples (United States Surgical, Norwalk, Connecticut) to facilitate laparoscopic reduction pelvioplasty during laparoscopic pyeloplasty. Of the 17 cases of reduction pelvioplasty closure was done in 12 using absorbable sutures, while in 5 reduction was done with an Endo-GIA stapler. Followup consisted of office visits and telephone interviews plus radionuclide renal scans. Average operative time was 5.5 hours in the Endo-GIA group compared with 6.8 hours in the sutured group. In the latter group extravasation in 2 patients postoperatively was managed conservatively. There was no extravasation in the stapled group. At a median subjective followup of 27 months none of the 5 patients who underwent reduction with titanium staples had symptomatic nephrolithiasis, although new onset urolithiasis developed in 1 in the sutured group. All patients had a greater than 50% decrease in pain. Renal scans at a median of 9 months showed that all ureteropelvic junction repairs were unobstructed. Additional radiographic studies in 2 patients in the stapled group showed a patent ureteropelvic junction and no stones. Conclusions: Titanium staples provide rapid, secure closure of the renal pelvis during laparoscopic pyeloplasty. While the risk of stone formation is an ongoing concern, it has yet to materialize.Keywords
This publication has 10 references indexed in Scilit:
- Newer techniques in intracorporeal tissue approximation: Suturing, tissue adhesives, and microclipsUrologic Clinics of North America, 2001
- Laparoscopic lower urinary tract reconstruction.World Journal of Urology, 2000
- LAPAROSCOPIC NEPHROURETERECTOMY FOR UPPER TRACT TRANSITIONAL CELL CANCER: THE WASHINGTON UNIVERSITY EXPERIENCEJournal of Urology, 2000
- HELICAL CT OF URINARY TRACT STONES: Epidemiology, Origin, Pathophysiology, Diagnosis, and ManagementRadiologic Clinics of North America, 1999
- Laparoscopic Ureteroureterostomy Using Vascular Closure Staples in Porcine ModelJournal of Endourology, 1998
- LAPAROSCOPIC PYELOPLASTYUrologic Clinics of North America, 1998
- Laparoscopic Pyeloplasty: Experience With the Initial 30 CasesJournal of Urology, 1997
- Laparoscopic Assisted Continent Urinary Diversion in the PigJournal of Urology, 1995
- Laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction: Preliminary experienceUrology, 1995
- Laparoscopic Stapled Bladder Closure: Laboratory and Clinical ExperienceJournal of Urology, 1993