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A comparison of renal vascular control techniques during laparoscopic nephrectomy
Gokhan Koc1, Gokhan Rahmi Ekin2, Batuhan Ergani1
1Department of Urology, Tepecik Teaching and Research Hospital, Izmir, Turkey.
Journal of Minimal Access Surgery
|March 16, 2021
Summary
En bloc stapler ligation is a safe and effective method for renal hilum ligation during laparoscopic nephrectomy. This technique showed no significant difference in complications or arteriovenous fistula formation compared to separate clip ligation.
Area of Science:
- Urology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Laparoscopic nephrectomy (LN) involves renal hilum ligation.
- Comparing en bloc stapler ligation versus separate Hem-o-lok clip ligation is crucial for surgical outcomes.
Purpose of the Study:
- To compare the outcomes of en bloc stapler ligation versus separate Hem-o-lok polymer clip ligation of the renal vessels during LN.
Main Methods:
- Retrospective analysis of clinical data from patients undergoing LN between January 2009 and December 2015.
- Evaluation of operative time, blood loss, device malfunction, open conversion, complications, and arteriovenous fistula (AVF) formation.
Main Results:
- No significant differences in operative time (P=0.147) or estimated blood loss (P=0.767) between the two groups.
- Higher open conversion rate in the en bloc stapler group (10.9% vs 3.0%, P=0.093) and stapler malfunction in 9.3% of cases.
- No statistically significant differences in overall, minor, or major complications (P > 0.05); no AVF formation observed in either group during follow-up.
Conclusions:
- En bloc stapler ligation of the renal hilum is an effective and safe technique in LN.
- While no AVF formation was reported, longer follow-up is recommended to confirm long-term safety.
