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  • Title: Ligation of the renal vein during laparoscopic nephrectomy: an effective and reliable method to replace vascular staplers.
    Author: Janetschek G, Bagheri F, Abdelmaksoud A, Biyani CS, Leeb K, Jeschke S.
    Journal: J Urol; 2003 Oct; 170(4 Pt 1):1295-7. PubMed ID: 14501745.
    Abstract:
    PURPOSE: Application of the endovascular gastrointestinal anastomosis stapler has become a standard procedure to control renal vein during laparoscopic nephrectomy. However, device malfunction resulting in significant complications has been reported. We present a safe and cost-effective technique for renal vein ligation during laparoscopic nephrectomy. MATERIALS AND METHODS: From October 2002 to April 2003 we applied our new technique of renal vein ligation in 20 cases. After renal pedicle dissection the renal artery was secured with Hem-o-lok (Weck Closure Systems, Research Triangle Park, North Carolina) clips. The renal vein was encircled with a suture, which was knotted extracorporeally and pushed down by a knot pusher to shrivel a vein of any size. Subsequently 10 mm Hem-o-lok clips were applied to the vein to occlude it completely. RESULTS: All procedures were successfully completed. The operative costs of vein ligation were decreased. There was no significant increase in mean operative time. CONCLUSIONS: Our approach is a safe, reliable, rapid and inexpensive method to ligate the renal vein during laparoscopic nephrectomy. Therefore, this technique has replaced endovascular gastrointestinal anastomosis stapler use at our center.
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