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Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy.

Kang Sup Kim1, Sae Woong Choi, Jeong Ho Kim

  • 1Department of Urology, The Catholic University of Korea College of Medicine , Seoul, Korea.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|November 26, 2014
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Summary

Running-clip renorrhaphy significantly reduces operative time, warm ischemic time (WIT), and intraoperative blood loss (IBL) during laparoscopic partial nephrectomy (LPN). This technique offers a safe and efficient approach for LPN procedures.

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Area of Science:

  • Urology
  • Surgical Techniques
  • Minimally Invasive Surgery

Background:

  • Laparoscopic partial nephrectomy (LPN) is a standard procedure for kidney tumor removal.
  • Minimizing warm ischemic time (WIT) and intraoperative blood loss (IBL) are critical for preserving renal function and patient outcomes.
  • Traditional renorrhaphy techniques can be time-consuming and contribute to prolonged WIT and IBL.

Purpose of the Study:

  • To introduce and evaluate a novel knotless running suture technique with Hem-o-lok clips for renal parenchyma closure (running-clip renorrhaphy).
  • To compare the running-clip renorrhaphy technique against traditional interrupted knot-tying suture renorrhaphy in terms of WIT and IBL during LPN.
  • To assess the safety and efficiency of running-clip renorrhaphy for LPN.

Main Methods:

  • A retrospective comparative study was conducted on patients undergoing LPN.
  • Group I (n=28) underwent LPN using traditional interrupted knot-tying suture renorrhaphy (2008-2010).
  • Group II (n=51) underwent LPN using the running-clip renorrhaphy technique (2011-2013).
  • Comparative analysis focused on operative time, WIT, and IBL between the two groups.

Main Results:

  • All LPN procedures were successfully completed without conversion to open surgery.
  • The running-clip renorrhaphy group (Group II) demonstrated significantly reduced operative time (148.7±31.9 min vs. 170.0±27.0 min), WIT (21.5±5.8 min vs. 32.3±6.5 min), and IBL (254±162 mL vs. 369±201 mL) compared to the traditional group (Group I).
  • No significant differences were found in patient demographics (age, BMI) or preoperative renal function (eGFR) between the groups.

Conclusions:

  • Running-clip renorrhaphy is an effective technique for reducing operative time, WIT, and IBL during LPN.
  • The technique is safe, efficient, and offers advantages over traditional renorrhaphy methods for LPN.
  • This method represents an advancement in surgical techniques for partial nephrectomy.