A novel technique: hemostatic agents for port-site closure post robotic-assisted urological surgeries. a pilot study

Abstract

Background: Many techniques and devices are used to close the surgical ports post minimally invasive procedures. However, they have limitations and may entail complications such as hernia, infection and dehiscence. This paper proposes novel plugging technique for port-site closure using a hemostatic agent to overcome these limitations and lower the complication rate. Objective: To assess the safety and efficacy of a novel Surgicel® plug technique for portsite closure post minimally invasive urological surgeries. Methods: A retrospective study conducted at King Fahad Medical City/Riyadh/Saudi Arabia with 114 sample size. Patients included are those who underwent robotic assisted urological surgery (from January 2010 to December 2013) in which their port-sites were closed by the novel Surgicel® plug technique with a minimum of 5-years follow-up period. All data were statistically analyzed using SPSS (version 23). Descriptive variables were presented as numbers and percentages. Patient demographics, type of surgery, and followup results. Resuls: A total of 114 patients were collected. 50 were males with a mean age of 41.9 (SD=18.2) and 64 were females with a mean age of 39.2 (SD=18.3). The male-female ratio is 1:1.2. In total, two cases (1.7%) developed port-site non-infectious discharge during radical nephrectomy and pyeloplasty, and one case (0.8%) developed port-site hernia during ureteric reimplantation. 111 cases (97.3%) had no port-site complications. Conclusion: This study showed that the novel plugging technique of port-site closure post minimally invasive urological procedures using a hemostatic agent (Surgicel®) is feasible, safe, easy, and effective in the group of patients studiedand could be considered as a newapproachfor trocar sites closure.