Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy.

Abstract

In this study, we report a simple closure technique of the renal parenchyma using a knotless running suture with Hem-o-lok(®) (Teleflex(®) Medical, Research Triangle Park, NC) clips (running-clip renorrhaphy) to minimize warm ischemic time (WIT) and reduce intraoperative blood loss (IBL). From 2008 to 2010, laparoscopic partial nephrectomy (LPN) was performed by traditional interrupted knot-tying suture renorrhaphy (Group I; n=28). Since then, from 2011 to 2013, LPN was performed by running-clip technique renorrhaphy (Group II; n=51). A comparative analysis of WIT and IBL between Groups I and II patients was investigated. All the LPNs were performed successfully without open conversion. No significant differences were observed for patients of different ages, body mass indexes, and preoperative estimated glomerular filtration rates. In Group I, the operative time, WIT, and IBL were 170.0±27.0 minutes, 32.3±6.5 minutes, and 369±201 mL, respectively. In Group II, the operative time, WIT, and IBL were 148.7±31.9 minutes, 21.5±5.8 minutes, and 254±162 mL, respectively. There was significant difference in operative time, WIT, and IBL between Groups I and II (P=.004, .001, and .008, respectively). The running-clip renorrhaphy reduced operative time, WIT, and IBL during the LPN. Therefore, running-clip renorrhaphy is a safe, efficient, and operative technique for performing the LPN.