Hemostatic techniques during laparoscopic partial nephrectomy.
OBJECTIVE
To review the current techniques and technologies being used for hemostatic control during laparoscopic partial nephrectomy.


RESULTS
Laparoscopic nephron-sparing surgery has become more common for the treatment of renal masses. With increasing experience, the indications for nephron sparing are increasing. Despite the increased use of these techniques in high-volume centers, however, more widespread application has been limited because of the need for advanced laparoscopic skills including the laparoscopic control of intraoperative renal bleeding. As a result, many techniques have been developed to achieve hemostasis, including conventional suture repair, tissue sealants, radiofrequency ablation, lasers, water dissection, and microwave tissue coagulation.


CONCLUSIONS
Laparoscopic partial nephrectomy is a technically challenging procedure. Many promising techniques are being developed currently, most geared toward improved hemostasis and collecting system repair. These techniques and products have made, and will continue to make, the procedure less demanding and more universally accepted.
Walters
Rustin Chanc
RC
Urology Department, Naval Medical Center San Diego, San Diego, California 92134-7200, USA.
Collins
Michelle Marie
MM
L'Esperance
James Omer
JO
D000269:Adhesives / Q000627:therapeutic use; D000465:Algorithms; D017115:Catheter Ablation / Q000379:methods; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D053685:Laser Therapy; D008872:Microwaves / Q000627:therapeutic use; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D000078702:Radiofrequency Therapy; D013536:Suture Techniques
D000269:Adhesives