Retroperitoneoscopic left donor nephrectomy: use of Hem-o-Lok clips for control of renal pedicle

To assess the safety of transplantation with the use of Hem-o-lok clips to control the renal vessels during retroperitoneoscopic donor nephrectomy (RDN).

From September 2004 to August 2005, we performed 45 left RDNs. Forty-one patients had a single renal artery, whereas four had double arteries. All patients had a single renal vein. Both the renal artery and the vein were controlled by 10-mm Hem-o-lok clips (Weck Closure Systems, Research Triangle Park, NC). Two clips for each artery and vein were applied on the patient side. The technical difficulty in obtaining vascular control, transfusion requirement, and clinical outcome were evaluated.

Sufficient length of renal vessels for transplantation was available in all patients. One patient required conversion to open surgery because of an injury to the renal artery during withdrawal of the clip applicator. The mean operative time was 206 minutes, and two patients required blood transfusion. The mean warm ischemia time was 254 seconds (range 134-520 seconds). Postoperatively, one patient had pneumopericardium. The mean postoperative stay was 3.5 days (range 1-8 days).

Hem-o-lok clips provide reliable vascular control in RDN and yield sufficient vessel length for transplantation.