Ces Urol 2007, 11(2):89-92 | DOI: 10.48095/cccu2007008

Hilar vascular occlusion during laparoscopic nephrectomy by means of locking clips

M. Hora¹, J. Klečka¹, V. Eret¹, J. Ferda²

¹ Urologická klinika LF UK a FN, Plzeň

² Radiologická klinika LF UK a FN, Plzeň

Aim: The stapler is the standard of care for occlusion of hilar vessels during laparoscopic nephrectomy. This paper aims to evaluate the possibility of replacing the stapler by locking clips.

Methods and Results: Between April 2005 and November 2005, a total of 35 hilar vascular occlusions during laparoscopy (24 radical nephrectomies for a tumour, 7 nephrectomies for a benign disease, and 4 nephroureterectomies) were performed. The procedures were done by three operators. Two operators with less experience in laparoscopy used a stapler in all 20 procedures. One more experienced operator carried out 15 hilar occlusions. In 12 (80 %) cases, both the artery and vein were occluded separately by means of locking clips. In three cases, occlusion was achieved using en bloc hilar stapling (topographically more complex relations of the renal vessels or more prominent vascular anomalies).

Conclusion: Renal vein closure by means of locking clips is a safe method. It is more time consuming since it requires preparation of the entire hilum and thus a highly skilled operator. However, this method is significantly cheaper than occlusion with a stapler.

Keywords: laparoscopy, nephrectomy, stapler, clips

Published: March 1, 2007