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A review of methods for hemostasis and renorrhaphy after laparoscopic and robot-assisted laparoscopic partial
Rajan Ramanathan1, Raymond J Leveillee
1Division of Endourology, Laparoscopy and Minimally Invasive Surgery, Department of Urology, Miller School of Medicine, University of Miami, 1400 NW 10th Avenue, Dominion Tower Suite 507, Miami, FL, 33136, USA. rajan.ramanathan@yahoo.com
Abstract:
The techniques for management of small renal masses (SRMs) have evolved over the past several years. Radical nephrectomy can lead to an increased risk of chronic kidney disease, and the emphasis is now shifting to nephron-conserving techniques. Partial nephrectomy is now considered a standard of care for the management of SRMs, and laparoscopic techniques are becoming popular because they are minimally invasive. The kidneys are extremely vascular organs, and renal hemorrhage is a major cause of morbidity after laparoscopic partial nephrectomies. Control of bleeding and management of calyceal injuries can be difficult and make the procedure technically challenging. This review looks at the various modalities that are available to reduce bleeding and reviews some advances in the area of hemostatic maneuvers during laparoscopic partial nephrectomies.

