Use of titanium staples during upper tract laparoscopic reconstructive surgery: Initial experience

Robert L. Grubb, Chandru Sundaram, Yan Yan, Cathy Chen, Elspeth M. McDougall, Ralph V. Clayman

Research output: Contribution to journalArticle

24 Citations (Scopus)

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: 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.

Original languageEnglish (US)
Pages (from-to)1366-1369
Number of pages4
JournalJournal of Urology
Volume168
Issue number4 I
StatePublished - Oct 2002
Externally publishedYes

Fingerprint

Reconstructive Surgical Procedures
Titanium
Laparoscopy
Urinary Tract
Kidney
Office Visits
Nephrolithiasis
Kidney Pelvis
Urolithiasis
Operative Time
Radioisotopes
Sutures
Interviews
Pain

Keywords

  • Kidney
  • Laparoscopy
  • Surgical stapling
  • Titanium
  • Ureteral obstruction

ASJC Scopus subject areas

  • Urology

Cite this

Grubb, R. L., Sundaram, C., Yan, Y., Chen, C., McDougall, E. M., & Clayman, R. V. (2002). Use of titanium staples during upper tract laparoscopic reconstructive surgery: Initial experience. Journal of Urology, 168(4 I), 1366-1369.

Use of titanium staples during upper tract laparoscopic reconstructive surgery : Initial experience. / Grubb, Robert L.; Sundaram, Chandru; Yan, Yan; Chen, Cathy; McDougall, Elspeth M.; Clayman, Ralph V.

In: Journal of Urology, Vol. 168, No. 4 I, 10.2002, p. 1366-1369.

Research output: Contribution to journalArticle

Grubb, RL, Sundaram, C, Yan, Y, Chen, C, McDougall, EM & Clayman, RV 2002, 'Use of titanium staples during upper tract laparoscopic reconstructive surgery: Initial experience', Journal of Urology, vol. 168, no. 4 I, pp. 1366-1369.
Grubb, Robert L. ; Sundaram, Chandru ; Yan, Yan ; Chen, Cathy ; McDougall, Elspeth M. ; Clayman, Ralph V. / Use of titanium staples during upper tract laparoscopic reconstructive surgery : Initial experience. In: Journal of Urology. 2002 ; Vol. 168, No. 4 I. pp. 1366-1369.
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