Use of Hem-o-lok clips effectively lengthens renal vein during laparoscopic live donor nephrectomy

We retrospectively reviewed our last 12 laparoscopic donor nephrectomies (LDNs) in which both the renal artery and the renal vein were controlled using 2 Hem-o-lok clips (Weck Closure Systems, Research Triangle Park, NC, United States) on the proximal sides and the vessels were divided without securing the graft-side vessels (group 1). We compared the results with our 12 immediately preceding LDN donors in whom the arteries were controlled with 3 endoclips and the veins were controlled with staplers (group 2). The length of the vein was significantly longer (approximately 4 mm difference) in group 1, mainly due to trimmed staples from the graft vessels. Both cohorts of donors had uneventful surgery with no complications, and all the recipients recovered smoothly without any delayed graft function. Average operation time and warm ischemia time were similar among both groups (189 vs 207 minutes; 168 vs 149 seconds, respectively; both P > .1). We conclude that the use of Hem-o-lok effectively lengthens graft renal veins and is less costly during LDN.