Laparoscopic Surgical Glue Injection Hernioplasty: A Single-Institution Experience
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The aim of this study was to provide clinical evidence supporting the safety and effectiveness of laparoscopic surgical glue injection hernioplasty (LSGIH) for indirect inguinal hernia repair in female patients.We conducted a prospective study of LSGIH beginning in January 2013. N-butyl-2-cyanoacrylate was used as the surgical glue for closure of the hernia sac. Twenty-eight female patients with a mean age of 51.1 ± 35.3 months (24 days to 10 years) received LSGIH. The total number of LSGIH operations was 42, including bilateral inguinal hernioplasties.Postoperatively, all the patients were discharged from the hospital within 24 hours without incident. The mean operation time for LSGIH was 41.0 ± 9.7 minutes (30-66 minutes). The mean follow-up period was 23.2 ± 8.3 months (14.6-38.2 months) up to now. There were no postoperative complications or recurrences during the follow-up period.Our prospective study supports LSGIH as a simple, safe, and useful technique for pediatric inguinal hernioplasty. This method required only one working port and one camera port. However, further clinical prospective trials, including male patients, should be performed to confirm the long-term safety and effectiveness of LSGIH.Keywords:
GLUE
Port (circuit theory)
Cyanoacrylate glue is a rapidly polymerizing agent used for vascular embolization. Polymerization occurs when the glue comes into contact with ions in the blood or on the vascular endothelium. Mixing iophendylate with cyanoacrylate causes slowing of polymerization, allowing flow-directed embolization into the nidus of an arteriovenous malformation (AVM) or the central neovascularity of a tumor or hemangioma. The authors attempted to define the relationship between the iophendylate-glue ratio and polymerization time with an in vivo swine model. In this model, glue setup occurred much more rapidly than predicted on the basis of in vitro studies. This appeared to be due to glue polymerizing on the endothelium at vessel bifurcations and at areas of acute angulation or marked vessel narrowing. On the basis of these data, the authors substantially increased the iophendylate-glue ratio in their most recent AVM embolization procedures and achieved nidus occlusion in each case. With use of the authors' guidelines, it is possible to achieve optimal distal flow-directed embolization with cyanoacrylate.
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In our burn unit, we used Glubran cyanoacrylate glue until 2017, but thereafter had problems obtaining it. Since 2018, we have gained some experience using a new glue called INDERMIL flexifuze. It is supplied as a sterile liquid topical tissue adhesive. It is composed of an octyl blend cyanoacrylate formulation that is not associated with perceptible heat release upon application. It acts as a physical barrier to microbial penetration as long as the adhesive film remains intact. The skin graft must be set in position before the glue is opened. Meticulous haemostasis before graft application is needed. In addition, the surrounding areas must be cleaned and dried. The glue is then applied at 1 - 2 cm intervals. The skin graft can then be dressed in a standard fashion. We have used it in 30 cases, with 100% graft take. We have found INDERMIL flexifuze to be a very effective glue for atraumatic skin graft fixation, and recommend its use.
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Cyanoacrylates
Penetration (warfare)
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Rabbit (cipher)
Nanochemistry
Cyanoacrylates
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The authors report four cases of patients in desperate clinical situations where cyanoacrylate adhesive (Krazy Glue) was successfully used to control hemorrhage. Clinical observations were supplemented with bacteriological studies which showed that commercially available cyanoacrylate adhesive showed lack of bacteriological contamination. (J Card Surg 1994;9:353–356)
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Histoacryl glue (N-butyl-2-cyanoacrylate) has well-established utility in the endoscopic management of gastrointestinal variceal bleeding. The role of Histoacryl glue in non-variceal bleeding is less clear, and there are few articles describing its use in this setting.Six patients with intractable non-variceal gastrointestinal bleeding were managed using injection of Histoacryl glue. All patients had previously failed conventional endostasis and/or interventional angioembolization and were not suitable for emergency salvage surgery due to serious comorbidities or unacceptable anaesthetic risk. An endoscopic Lipiodol-Histoacryl-Lipiodol sandwich injection technique was used in these patients. The clinical outcomes and complications were evaluated.There were four females and two males with a mean age of 55 years. Bleeding lesions included gastric ulcers (n = 2), duodenal ulcers (n = 2), duodenal gastrointestinal stromal tumor (GIST) (n = 1) and rectal ulcers (n = 1). All patients had successful Histoacryl endostasis without the requirement for salvage surgery. There was no treatment-related morbidity and no mortality. Two patients had further bleeding after initial Histoacryl endostasis, which was successfully controlled with further endoscopic Histoacryl injection.Histoacryl endostasis should be included in the treatment algorithm for refractory non-variceal gastrointestinal bleeding.
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Cyanoacrylates
Refractory (planetary science)
Gastrointestinal bleeding
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Successful treatment of esophageal fistulas with endoscopic injection of alpha-cyanoacrylate monomer
The application of glue is an established treatment for fistulas [1] [2]. We consider that the alpha-cyanoacrylate monomer (α-CA) is ideal for glue embolization of intractable fistulas in the gastrointestinal tract because the α-CA glue spreads faster, so creating a bond more rapidly than the other polymer glues, such as n-butyl cyanoacrylate polymer and 2-octyl cyanoacrylate polymer [3]. However, there have been few reports of successful fistula closure using α-CA glue [4].
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A case of 21-year-old woman with postraumatic giant direct carotid-cavernous fistula, successfully treated by endovascular embilisation with cyanoacrylate glue, is presented. Stent-assisted coils placement is the method of choice for the treatment of patients with carotid-cavernous fistulas, but closure of direct fistula with cyanoacrylate glue can be alternative, safety and efficient technique especially in cases in which standard interventions offer increased risk or in which other methods have failed.
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No AccessJournal of UrologyINVESTIGATIVE UROLOGY1 Apr 2002Use Of Absorbable Cyanoacrylate Glue To Repair An Open Cystotomy Brian D. Seifman, Mark A. Rubin, Antoinette L. Williams, and J. Stuart Wolf Brian D. SeifmanBrian D. Seifman More articles by this author , Mark A. RubinMark A. Rubin More articles by this author , Antoinette L. WilliamsAntoinette L. Williams More articles by this author , and J. Stuart WolfJ. Stuart Wolf Financial interest and/or other relationship with USSC, Closure Medical and Dexterity. More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65252-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A biodegradable cyanoacrylate glue was tested for its ability to close bladder injuries in an established porcine model. Inflammation and encrustation associated with this glue were examined in a rabbit model. Materials and Methods: Four domestic pigs underwent transverse cystotomy, which was closed with absorbable cyanoacrylate glue. Four weeks later the bladder was distended with normal saline to evaluate the repair. A total of 45 rabbits underwent cystotomy, which was closed with polyglactin suture, absorbable cyanoacrylate glue or nonabsorbable 2-octyl cyanoacrylate glue. The bladder was harvested at 4 or 12 weeks to evaluate inflammation, microcalcification and encrustation. Results: All 4 pig bladders tolerated a pressure of 200 mm. Hg 4 weeks after closure. In the rabbit bladders there was no difference in inflammation in the groups at 4 and 12 weeks. The absorbable glue and suture groups had less microcalcification than the 2-octyl cyanoacrylate glue group at 4 and 12 weeks (p = 0.01 and 0.02, respectively). Encrustation was less in the suture and absorbable glue groups than in the 2-octyl cyanoacrylate glue group at 4 and 12 weeks (p = 0.004 and 0.02, respectively). Conclusions: An experimental absorbable cyanoacrylate glue has the strength to seal a large cystotomy. The inflammatory response to absorbable glue is similar to that to suture at 12 weeks. Absorbable glue does not promote calcification. These properties may make it a suitable material for replacing or augmenting suture in the urinary tract. References 1 : Experimental use of fluoroalkyl cyanoacrylate in ureteral anastomosis. Invest Urol1978; 15: 416. Google Scholar 2 : Experimental evaluation of tissue adhesives in urogenital surgery. J Urol1964; 162: 113. Google Scholar 3 : Potential use of tissue adhesive in urinary tract surgery. Br J Urol1992; 69: 647. Google Scholar 4 : Comparison of 2-octyl cyanoacrylate adhesive, fibrin glue, and suturing for wound closure in the porcine urinary tract. Urology1999; 57: 806. Google Scholar 5 : A randomized trial comparing octylcyanoacrylate tissue adhesive and sutures in the management of lacerations. JAMA1997; 277: 1527. Google Scholar 6 : Antifibrinolytic additives to fibrin glue for laparoscopic wound closure in the urinary tract. J Endourol1999; 13: 283. Google Scholar 7 : Surgical adhesives. Ann N Y Acad Sci1968; 146: 214. Google Scholar 8 : Urolithiasis on absorbable and non-absorbable suture materials in the rabbit bladder. J Urol1986; 135: 602. Link, Google Scholar 9 : Fibrin sealant adhesion systems: a review of their chemistry, material properties, and clinical applications. J Biomat Appl1993; 7: 309. Google Scholar 10 : Fibrin glue for partial nephrectomy. Urology1991; 38: 314. Crossref, Medline, Google Scholar 11 : Nephron-sparing surgery for suspected malignancy: open surgery compared to laparoscopy with selective use of hand-assistance. J Urol2000; 163: 1659. Abstract, Google Scholar 12 : Fibrin glue in renal and ureteral trauma. Urology1989; 33: 215. Google Scholar 13 : Cryoprecipitate coagulum as an adjunct to surgery for diverticula of the female urethra. J Urol1981; 126: 698. Link, Google Scholar 14 : Anwendung des humanfibrinklebers beim verschluss von blasen-scheiden-fisteln. Urol Int1985; 40: 141. Google Scholar 15 : Local hemostasis of nephrostomy tract with fibrin adhesive sealing in percutaneous nephrolithotomy. Eur J Urol1987; 13: 118. Google Scholar 16 : Extraperitoneal laparoscopic dismembered fibrin-glued pyeloplasty: medium-term results. Br J Urol1997; 80: 382. Google Scholar 17 : Current status of surgical adhesives. J Surg Res1990; 48: 165. Google Scholar 18 : An experimental study of the effects of a plastic adhesive, methyl 2-cyanoacrylate monomer (M 2 C-1) in various tissues. J Neurosurg1966; 24: 876. Google Scholar 19 : An alternative to sutures. MEDSURG Nursing2000; 9: 83. Google Scholar 20 : A traumatic ossicular disruption successfully repaired with n-butyl cyanoacrylate tissue adhesive. J Laryngol Otolaryngol2000; 114: 130. Google Scholar 21 : n-Butyl 2-cyanoacrylate substitute for IBCA in interventional neuroradiology: histopathological and polymerization studies. AJNR1989; 10: 777. Google Scholar 22 : Management of incurable urinary fistulas by percutaneous ureteral occlusion. Obstet Gynecol1987; 70: 958. Google Scholar 23 : Experimental evaluation of tissue adhesives in urogenital surgery. J Urol1964; 92: 56. Link, Google Scholar From the Departments of General Surgery (Section of Urology) and Pathology, Veterans Affairs Medical Center and University of Michigan Health System, Ann Arbor, Michigan© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySOFER M, GREENSTEIN A, CHEN J, NADU A, KAVER I and MATZKIN H (2018) Immediate Closure of Nephrostomy Tube Wounds Using a Tissue Adhesive: A Novel Approach following Percutaneous Endourological ProceduresJournal of Urology, VOL. 169, NO. 6, (2034-2036), Online publication date: 1-Jun-2003. Volume 167Issue 4April 2002Page: 1872-1875 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsbladderswinerabbitscyanoacrylatestissue adhesiveMetrics Author Information Brian D. Seifman More articles by this author Mark A. Rubin More articles by this author Antoinette L. Williams More articles by this author J. Stuart Wolf Financial interest and/or other relationship with USSC, Closure Medical and Dexterity. More articles by this author Expand All Advertisement PDF downloadLoading ...
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Absorbable suture
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Purpose To report a case of idiopathic corneal perforation with chronic inflammation in the setting of a persistent cyanoacrylate corneal glue patch lasting 420 days. Observations Cyanoacrylate glue is a fast-acting and effective adhesive which has been utilised in the repair of corneal perforations. Their strength, quick drying, non-biodegradable and anti-microbial properties make them a valuable tool in closing small corneal wounds, often as a temporising measure before definitive management is performed. Complications associated with cyanoacrylate patch include glue toxicity, inflammation, corneal neovascularisation and giant papillary conjunctivitis. Conclusions Cyanoacrylate glue should be considered a transitory measure. It is preferable to remove cyanoacrylate at the end of the treatment unless the glue has self-dislodge. Controversies surround the issue of selecting proper timing for removal of cyanoacrylate glue with no clear consensus.
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Corneal perforation
Cyanoacrylates
Perforation
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