Comparison of three different haemostatic agents during laparoscopy on renal bleeding in rabbits

In many of renal disorders such as small renal tumours or cortical renal stones, patients will be in a need of surgery such as nephrotomy or partial nephrectomy. These surgeries could be performed using laparoscopic devices to reduce the risk of internal infections. Despite laparoscopic nephrotomy (LN) approach has long been the choice of surgeons, bleeding management also remains a major surgical challenge. In this study, 25% aluminum chloride solution, 15.5% ferric sulphate solution and oxidised cellulose (Surgicel^®, Ethicon, USA) were used along with a bipolar electrocautery device for blood coagulation during LN surgery in laboratory rabbits. A 5-10 mm lesion resected on the capsule and cortex of both kidneys in all 5 rabbits in each group and immediately one of the chosen haemostatic methods applied. Duration of surgery and duration of blood coagulation time, biochemical characteristics, pathological and haematological data were examined. The results showed that the Surgicel group was the best method for haemostasis during LN with a statistically significant difference compared to the control group. Also, considering the duration of surgery and the duration of bleeding, the control group with 7.2 ± 2.28 seconds has the shortest duration of coagulation time, while the Surgicel treatment group with 10 ± 1.41 seconds coagulation time, have no significant difference with control group. Therefore, while providing best haemostasis, Surgicel has the shortest possible coagulation time and the least renal cortex and capsule degeneration.