Nephron Sparing Surgery for Renal Cell Carcinoma Using Selective Renal Parenchymal Clamping

Abstract

Selective renal parenchymal clamping is a simple and efficient technical maneuver for facilitating nephron sparing surgery without pedicle dissection and clamping for renal peripheral or pole tumors. Neoplasm location and size are the limiting factors of this technique.

Initial results of selective renal parenchymal clamping with an adjustable kidney clamp in nephron-sparing surgery: an easy way to minimise renal ischaemia

“…This was mainly attributed by the time saved for the tedious and sometimes risky hilar dissection. 19 Renal cooling with ice was also unnecessary and further reduced the overall operating time. The lower estimated blood loss could be explained by the avoidance of HC, as vascular injury during HC can lead to profuse bleeding 10 or even renal artery dissection.…”

Partial nephrectomy for renal tumors using selective parenchymal clamping

“…However, renal-pedicle clamping can lead to ischemia, reperfusion injury and temporal or definite loss of renal function requiring dialysis [4,6,7]. Recently, a technical modification using selective parenchymal clamping has been described [6,7], which allows removing renal tumors without clamping renal pedicle, therefore, avoiding ischemia in the remaining renal tissue.…”

The purse‐string suture in nephron‐sparing surgery for renal cell carcinoma

“…Some authors do not consider the harmonic scalpel to be as efficient in controlling bleeding, but our experience with purse-strings combined with the harmonic scalpel was satisfactory [10]. During the procedure the kidney does not need to be so extensively exposed, as recently reported with the use of a DeBakey aortic clamp [11]. The favourable low blood loss during and after surgery was mostly attributed to the sustained and more durable blood vessel control in the renal cavity by the purse-string, as it was the only major difference in the management of the present patients.…”