Another novel application of Hem-o-Lok clips for transient vascular occlusion in robot-assisted laparoscopic partial nephrectomy: an alternative to laparoscopic bulldog and Satinsky clamps

Journal of Endourology
Henry HoGeorg Bartsch

Abstract

We describe our technique of achieving transient vascular occlusion utilizing Hem-o-Lok clips during robotassisted laparoscopic partial nephrectomy (RLPN) A once-folded vascular loop is threaded through a 2-cm feeding tube. After passing around the renal vessel, its tail goes through the U-loop, creating a tourniquet. Vascular occlusion begins when the tube slides towards the vessel and a Hem-o-Lok clip is applied on the vascular loop next to the exposed end of the tube. When no longer needed, it is released. Since July 2006, 25 patients underwent RLPN utilizing this technique, which required <15 seconds to deploy for any vessel size. There were eight patients with multiple vessels. The mean operative time was 82.6 minutes, and the mean warm ischemia time was 22 minutes (range 17-27 minutes). There were no cases of intraoperative or postoperative bleeding. The technique is simple, inexpensive, and applicable to multiple vessels. It is a viable alternative to standard vascular occlusion techniques, such as laparoscopic bulldog or Satinsky clamps.

References

Feb 22, 2005·BJU International·Andrew C Novick, Ithaar Derweesh
Feb 22, 2005·BJU International·Mihir M Desai, Inderbir S Gill
May 15, 2007·European Urology·Grégory VerhoestJean-Jacques Patard
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Nov 29, 2007·Journal of Endourology·Nasser SimforooshAhmad Javaherforooshzadeh

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Citations

Feb 26, 2011·International Urology and Nephrology·Paurush Babbar, Ashok K Hemal
Sep 24, 2011·BJU International·Harveer S DevChristopher J Anderson
Apr 14, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P ModiH Trivedi
Apr 27, 2011·BJU International·Alex SheflerGünter Janetschek
Mar 31, 2018·Journal of Robotic Surgery·Konstantinos StravodimosConstantinos Constantinides
Mar 1, 2012·Arab Journal of Urology·Humberto Laydner, Jihad H Kaouk
Feb 15, 2014·Urologia·Cristian FioriFrancesco Porpiglia

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