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2020 CUA Abstracts





        obstruction, of which six had laparoscopic pyeloplasty and 16 are being   MP-5.13
        followed. Twenty-four patients (22%) were diagnosed with non-obstruc-  Hemopatch parenchymal closure technique and initial outcomes
        tive hydronephrosis, with 88% (21/24) discharged to primary care. Of   during robot-assisted partial nephrectomy
        the remaining 61 patients, 15% (9/61) required intervention, 51% (31/61)   Benjamin Beech , Ryan McLarty , Jan K. Rudzinski , Howard J. Evans 1
                                                                         1
                                                                                   1
                                                                                                1
        are being followed, and 34% (21/61) were discharged from urology care.  1 Division of Urology, University of Alberta, Edmonton, AB, Canada
        Conclusions: Based on these findings, we believe that a care pathway   Introduction: The Hemopatch is a novel polyethylene glycol-coated (PEG-
        for hydronephrosis patients can be developed for our triage team to help   coated) collagen patch that acts as a topical hemostatic agent. It has been
        expedite the referral process and prioritize patients based on clinical need.  applied to a variety of surgical techniques. Here, we present our initial
        References                                           series using it for robot assisted laparoscopic partial nephrectomy (RAPN).
        1.   Greco Baldea, Kristin A. Renal, Upper Tract Obstruction. American   Methods: We conducted a retrospective review of all patients undergoing
            Urological Association. Oct. 2, 2018. Available at: https://univer-  RAPN by a single surgeon at a tertiary Canadian medical center between
            sity.auanet.org/modules/webapps/core/index.cfm#/corecontent/62.   July and December 2018. We excluded patients if they did not have 90
            Accessed April 23, 2020.                         days followup or a Hemopatch was not used on the renal parenchymal
        2.   Singh, IM, Strandhoy JW, Assimos DG. Pathophysiology of Urinary   defect. We collected data pertaining to demographics, renal tumor com-
            Tract Obstruction. In: Kavoussi L, Novick A, Partin A, Peters C,   plexity (RENAL nephrometry score), and postoperative outcomes. This
            eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier-  included 90-day complications (Clavien-Dindo classification), 90-day
            Saunders; 2012:1087-1108. https://doi.org/10.1016/B978-1-4160-  arterial embolization, estimated blood loss (EBL), change in postopera-
            6911-9.00040-2                                   tive hemoglobin, clamp method, and length of stay (LOS). Descriptive
                                                             statistics were used to examine our outcomes. We also describe in detail
        MP-5.12                                              our “gloved sleeping bag” technique for Hemopatch deployment.
        Evaluation of the new holmium laser Xpeeda TM  side-firing fiber   Results: Seventeen patients met inclusion criteria, of whom 12 were male.
        vs. Greenlight XPS 180W vapo-enucleation of the prostate for   Mean age was 63 years. Median size of renal mass was 2.85 cm in largest
        benign prostatic obstruction: An early clinical experience  dimension, and median RENAL score was 6. Hilar clamping was carried
        Ahmed Ibrahim , Mélanie Aube-Peterkin , Hazem Elmansy , Serge Carrier 1  out in 12 (70.9%) cases, with an average warm ischemic time of 16.1
                   1
                                   1
                                               2
                                             2
        1 Urology, McGill University, Montreal, QC, Canada;  Urology, Thunder   minutes. The remainder of cases were performed off-clamp. Median EBL
        Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada  was 238 mL and the mean change in hemoglobin on postoperative day
        Introduction: Recently, holmium Lumenis Pulse™ 120W was introduced   1 compared to preoperatively was 21.2 g/L. Average LOS was 1.76 days.
        and it stands apart from other available technologies as a combination   No patient underwent angioembolization for bleeding within 90 days
        of power and efficiency, which minimizes vaporization time. It delivers   and there were no complications greater than Clavien-Dindo grade 2.
        120W, which represent the highest holmium power on the market, with   One patient developed a urinary tract infection and a second developed
        better energy use through the new Xpeeda™ side-firing fiber. This tech-  postoperative urinary retention.
        nology seems to revolutionize use of the holmium power and delivering   Conclusions: Hemopatch can be used safely and effectively in lieu of tra-
        more energy directly to the tissue, due to its ability to be in contact with   ditional two-layer renorraphy with acceptable outcomes. Larger prospec-
        the tissue. Herein, we report our early clinical experience comparing both   tive series are required to ascertain its true value and cost-effectiveness.
        procedures in improving bothersome lower urinary tract symptoms (LUTS)
        secondary to benign prostatic hyperplasia (BPH).
        Methods: A prospective study comparing holmium laser Xpeeda  side-
                                                     ™
        firing fiber of the Lumenis Pulse 120W to photoselective vapo-resection of
        the prostate-XPS 180 W was conducted. International Prostate Symptom
        Score  (IPSS), flow rate, residual urine, prostate-specific antigen, and
        prostate volume changes, as well as perioperative complications were
        collected and compared.
        Results: Overall, 26 and 30 patients were included in the holmium laser
        Expeeda   side-firing (group A) and photoselective vapo-resection (group
                TM
        B), respectively. There were no significant differences in terms of operative
        time, hospital stay, and time to catheter removal between both groups
        (p>0.05). There was a significant comparable improvement in IPSS and
        post-void residual urine volume at one and four months. Re-intervention
        was needed in one and two cases in groups A and B, respectively (p=0.1).
        There were no significant difference between both groups in terms of
        intraoperative complications (1 vs. 2, p>0.05).
        Conclusions: Our early clinical experience suggests that the new holmium
        laser Xpeeda  side-firing fiber is safe, non-inferior, and effective in treat-
                 TM
        ment of BPH when compared with Greenlight XPS. Long-term followup
        and randomized clinical trials are definitely warranted to assess whether
        this new technology is more effective and more cost-effective.
                                                             MP-5.13. Fig. 1. Preparation and deployment of Hemopatch into renal mass
                                                             defect. (A) The Hemopatch is rolled with the adhesive side facing inward and
                                                             placed into the cut fifth finger of a sterile glove. (B) The assistant deploys the
                                                             glove finger into the field; (C, D) and the surgeon can manipulate the Hemo-
                                                             patch onto the defect without contact with surrounding tissues.






        S108                                    CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)
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