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Use of bipolar electrocautery during laparoscopic donor nephrectomy
1Section of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Purpose:
We describe a technique enabling easier placement of the endoscopic linear stapling device on the renal vein during laparoscopic nephrectomy.
Materials And Methods:
Bipolar electrocautery rather than a clip applier was used in 20 laparoscopic donor nephrectomy cases to coagulate the renal vein branches before transection. Warm ischemia time of the specimens and the number of surgical clip applier devices used were compared with those in the 20 immediate preceding cases in which bipolar electrocautery was not used.
Results:
Using bipolar electrocautery no clips were placed on the specimen side of the renal vein before stapling. Average warm ischemia time for the 20 kidneys in which bipolar electrocautery was performed was 2 minutes 13 seconds compared with 3 minutes 1 second for the previous 20 (p = 0.157). Significantly fewer clip applying devices were used in the 20 bipolar electrocautery cases (p = 0.005).
Conclusions:
Bipolar electrocautery of the renal vein branches enables easier placement of the endoscopic linear stapling device on the renal vein and the use of fewer surgical clip appliers during laparoscopic surgery. Because the bipolar electrocautery device is reusable, it decreases operative costs.