A Feasible Technique for Transient Vascular Occlusion by Using a Vessel Loop and Hem-o-Lok Clips in Laparoscopic Partial Nephrectomy
이윤형, 권준범, 조성룡, 김재수,
소속 상세정보
이윤형 ( Lee Yoon-Hyung )
Daegu Fatima Hospital Department of Urology
권준범 ( Kwon Joon-Beom )
Daegu Fatima Hospital Department of Urology
조성룡 ( Cho Sung-Ryong )
Daegu Fatima Hospital Department of Urology
김재수 ( Kim Jae-Soo )
Daegu Fatima Hospital Department of Urology
KMID : 0358320110520080543
Abstract
Purpose: We introduce our transient vascular occlusion technique that uses a vessel loop and Hem-o-Lok clips in laparoscopic partial nephrectomy.
Materials and Methods: From 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.
Results: All 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.
Conclusions: The 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.
키워드
Kidney neoplasms; Laparoscopy; Nephrectomy
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