12- sealing renal biopsies in bench surgery

Introduction and objective

Cyanoacrylate surgical glues have been widely used for sealing and hemostasis in distinct surgical specialties and interventions. In urology, these glues are highly useful in sealing surgical sutures to prevent bleeding and urinary extravasation in urinary tract surgery. We describe a new application of cyanoacrylate surgical glue: sealing renal graft biopsy during bench surgery in renal transplantation.

Methods

We applied several drops of Glubran ®2 surgical glue (N–butyl–2-cyano-acrylate and methacryloxysulfolane) over the orifice of the graft biopsy at bench surgery. The glue was left to set for 90s until completely polymerized, leaving the biopsy cavity completely sealed.

Results

We have used this procedure successfully since 2010. Cyanoacrylate polymerizes rapidly on contact with the renal tissue and is therefore ideal to reduce cold ischemia time. Among the 194 kidney transplantations performed, there was no active bleeding at the biopsy site on graft reperfusion, nor in any of the subsequent Doppler ultrasound follow-up examinations.

Conclusions

Renal biopsies are usually closed using a cruciate suture pattern. In our center, we prefer sealing with cyanoacrylate adhesive. This method avoids parenchymal laceration and bleeding after reperfusion. In our experience, this alternative is safe and effective.