M Kaushik1, A Bagul, P J Yates, R Elwell, M L Nicholson. 1. Department of Cardiovascular Sciences, Transplant Group, University Hospitals of Leicester, Leicester General Hospital, Leicester, LE5 4PW, United Kingdom.
Abstract
BACKGROUND: The objective of this study was to compare the safety and efficacy of three different methods to secure the renal vessels during laparoscopic donor nephrectomy (LDN). METHODS: Vessel lengths and intraoperative vascular complications were compared in a prospective series of 106 LDNs in which the vessels had been secured using a stapling device, metal clips, or polymer clips. RESULTS: One hundred six patients underwent LDN (right = 25, left = 81). Renal vein lengths were not significantly different after stapling or using polymer clips (36 +/- 10 vs 37 +/- 9 mm; P = .463). Renal arterial length was shorter after stapling (30 +/- 7 mm) compared with both endoclips (34 +/- 10 mm; P = .030) and polymer clips (34 +/- 8 mm; P = .030). There was one major arterial bleed in the endoclip group, one episode of stapler malfunction, but no adverse events with polymer clips. CONCLUSION: Polymer clips are safe and yield greater vessel lengths during LDN.
BACKGROUND: The objective of this study was to compare the safety and efficacy of three different methods to secure the renal vessels during laparoscopic donor nephrectomy (LDN). METHODS: Vessel lengths and intraoperative vascular complications were compared in a prospective series of 106 LDNs in which the vessels had been secured using a stapling device, metal clips, or polymer clips. RESULTS: One hundred six patients underwent LDN (right = 25, left = 81). Renal vein lengths were not significantly different after stapling or using polymer clips (36 +/- 10 vs 37 +/- 9 mm; P = .463). Renal arterial length was shorter after stapling (30 +/- 7 mm) compared with both endoclips (34 +/- 10 mm; P = .030) and polymer clips (34 +/- 8 mm; P = .030). There was one major arterial bleed in the endoclip group, one episode of stapler malfunction, but no adverse events with polymer clips. CONCLUSION:Polymer clips are safe and yield greater vessel lengths during LDN.