Use Of Titanium Staples During Upper Tract Laparoscopic Reconstructive Surgery: Initial Experience

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Oct 2002Use Of Titanium Staples During Upper Tract Laparoscopic Reconstructive Surgery: Initial Experience Robert L. Grubb, Chandru P. Sundaram, Yan Yan, Cathy Chen, Elspeth M. McDougall, and Ralph V. Clayman Robert L. GrubbRobert L. Grubb , Chandru P. SundaramChandru P. Sundaram , Yan YanYan Yan , Cathy ChenCathy Chen , Elspeth M. McDougallElspeth M. McDougall , and Ralph V. ClaymanRalph V. Clayman View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64450-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: 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. Materials and Methods: 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. Results: 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: 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. References 1 : Laparoscopic stapled bladder closure: laboratory and clinical experience. J Urol1993; 149: 1437. Link, Google Scholar 2 : Laparoscopic nephroureterectomy for upper tract transitional cell cancer: the Washington University experience. J Urol2000; 163: 1100. Link, Google Scholar 3 : Laparoscopic lower urinary tract reconstruction. World J Urol2000; 18: 349. Google Scholar 4 : Laparoscopic ureteroureterostomy using vascular closure staples in a porcine model. J Endourol1998; 12: 265. Google Scholar 5 : Laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction: preliminary experience. Urology1995; 46: 257. Google Scholar 6 : Laparoscopic pyeloplasty: experience with the initial 30 cases. J Urol1997; 157: 459. Link, Google Scholar 7 : Laparoscopic pyeloplasty: indications, technique, and long-term outcome. Urol Clin North Am1998; 25: 323. Google Scholar 8 : Laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction: Washington University Experience. J Urol2001; 165: 4. Google Scholar 9 : Newer techniques in intracorporeal tissue approximation: suturing, tissue adhesives, and microclips. Urol Clin North Am2001; 28: 15. Google Scholar 10 : Laparoscopic assisted continent urinary diversion in the pig. J Urol1995; 154: 1934. Link, Google Scholar 11 : Helical CT of urinary tract stones: epidemiology, origin, pathophysiology, diagnosis and management. Radiol Clin North Am1999; 37: 911. Google Scholar From the Departments of Surgery (Urology), Washington University School of Medicine, St. Louis, Missouri, Department of Surgery (Urology), Vanderbilt School of Medicine, Nashville, Tennessee, and Department of Urology, University of California, Irvine, Orange, California© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByFerriero M, Guaglianone S, Papalia R, Muto G, Gallucci M and Simone G (2018) Risk Assessment of Stone Formation in Stapled Orthotopic Ileal NeobladderJournal of Urology, VOL. 193, NO. 3, (891-896), Online publication date: 1-Mar-2015.Smith J (2018) RE: EDITORIAL COMMENT ON Y-NEOBLADDER: AN EASY, FAST, AND RELIABLE PROCEDUREJournal of Urology, VOL. 174, NO. 2, (792-792), Online publication date: 1-Aug-2005.EDEN C, GIANDUZZO T, CHANG C, THIRUCHELVAM N and JONES A (2018) EXTRAPERITONEAL LAPAROSCOPIC PYELOPLASTY FOR PRIMARY AND SECONDARY URETEROPELVIC JUNCTION OBSTRUCTIONJournal of Urology, VOL. 172, NO. 6 Part 1, (2308-2311), Online publication date: 1-Dec-2004. Volume 168Issue 4 Part 1October 2002Page: 1366-1369 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordslaparoscopytitaniumureteral obstructionkidneysurgical staplingMetricsAuthor Information Robert L. Grubb More articles by this author Chandru P. Sundaram More articles by this author Yan Yan More articles by this author Cathy Chen More articles by this author Elspeth M. McDougall More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF DownloadLoading ...