Clamping of the Renal Artery in Laparoscopic Partial Nephrectomy: An Old Device for a New Technique

Abstract

Objective: We describe our experience with the transient clamping of the renal artery during laparoscopic partial nephrectomy for renal cancer with a double loop clamping device, inspired by the Rumel tourniquet. The silastic rubber loop is positioned around the renal artery and clinched, thus achieving arterial occlusion. Methods: From November 2002 until July 2004, fourteen consecutive patients (mean age of 58 ± 11.6 years) underwent laparoscopic transperitoneal partial nephrectomy using the silastic rubber clamping device, eight of them on the right side and six on the left side. Hemorrhage of the renal defect was controlled with bipolar electrocoagulation, argon beam coagulation, laparoscopic sutures, surgicel and fibrin glue. Results: The mean surgical time was 198.92 ± 39.95 min for a mean tumour size of 2.9 ± 2.32 cm and a mean blood loss of 104.57 ± 77.69 ml. The clamping device was easily and successfully positioned around the renal artery in 2.05 ± 0.45 min and the mean warm ischemic time was 25.21 ± 6.07 min. Conclusions: The clamping device procures successful atraumatic occlusion of the renal artery during laparoscopic partial nephrectomy without the need for an additional port. As such, it could be considered as an alternative for the laparoscopic bulldog and Satinsky clamp.