Laparoscopic Partial Nephrectomy without Hilar Control

Jeon, Seong Soo; Kim, Isaac Yi

doi:10.1089/end.2008.9773

Cited by 4 publications

(2 citation statements)

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“…Indeed, it has been reported that exophytic lesions can be safely removed laparoscopically without controlling the renal hilum. [7][8][9] During the last 2 years, our institutional philosophy has been to avoid cross-clamping the renal vessels, if possible. Here, we report our experience.…”

Section: Introductionmentioning

confidence: 99%

Renal Hilar Control During Laparoscopic Partial Nephrectomy: To Clamp or Not to Clamp

Koo

Lee²,

Kim

2010

Journal of Endourology

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Section: Introductionmentioning

confidence: 99%

Renal Hilar Control During Laparoscopic Partial Nephrectomy: To Clamp or Not to Clamp

Koo

Lee²,

Kim

2010

Journal of Endourology

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“…The advancement of surgical techniques in laparoscopic and robotic surgery and the introduction of the ultrasonic knife have enabled operators to perform partial nephrectomy without renal artery clamping and to minimize the damage to renal function [21,22]. In the case of surgeries without renal artery clamping, however, operators may experience difficulty in performing the surgeries if they have not overcome the learning curve of laparoscopic or robotic surgeries.…”

Section: Discussionmentioning

confidence: 99%

A Feasible Technique for Transient Vascular Occlusion by Using a Vessel Loop and Hem-o-Lok Clips in Laparoscopic Partial Nephrectomy

2011

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PurposeWe introduce our transient vascular occlusion technique that uses a vessel loop and Hem-o-Lok clips in laparoscopic partial nephrectomy.Materials and MethodsFrom March 2009 to March 2011, 15 consecutive patients underwent laparoscopic partial nephrectomy. All operations were performed by a single surgeon using the transperitoneal approach. The transient vascular occlusion technique was as follows. After dissection of renal vessels, the vessel loop is winded twice around the vessel. Both distal portions of the vessel loop are clipped with a Hem-o-Lok clip. When vascular occlusion is required, an additional Hem-o-Lok clip is applied to the proximal portion of the vessel loop by pulling the distal portion. When no longer needed, the vessel loop is simply cut.ResultsAll operations were performed successfully without open conversion. The mean tumor size was 2.5 cm (range, 1.1-3.5 cm). There were 8 cases of renal cell carcinoma and 7 cases of angiomyolipoma. All cases of renal cell carcinoma had a negative surgical margin. The mean operative time and the mean warm ischemic time were 176 minutes (range, 104-283 minutes) and 26.1 minutes (range, 18-34 minutes), respectively. There were no cases of uncontrollable intraoperative bleeding and no postoperative complications.ConclusionsThe transient vascular occlusion technique with a vessel loop and Hem-o-Lok clips is a feasible technique with simplicity, effectiveness, and safety. It is an acceptable alternative to standard vascular occlusion techniques, such as laparoscopic bulldog or Satinsky clamps.

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Current World Literature

2010

Current Opinion in Urology

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Laparoscopic Partial Nephrectomy without Hilar Control

Cited by 4 publications

References 40 publications

Renal Hilar Control During Laparoscopic Partial Nephrectomy: To Clamp or Not to Clamp

Renal Hilar Control During Laparoscopic Partial Nephrectomy: To Clamp or Not to Clamp

A Feasible Technique for Transient Vascular Occlusion by Using a Vessel Loop and Hem-o-Lok Clips in Laparoscopic Partial Nephrectomy

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