Comparison of techniques of vascular control in laparoscopic donor nephrectomy: The leicester experience.
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.


CONCLUSIONS
Polymer clips are safe and yield greater vessel lengths during LDN.
Kaushik
M
M
Department of Cardiovascular Sciences, Transplant Group, University Hospitals of Leicester, Leicester General Hospital, Leicester, LE5 4PW, United Kingdom.
Bagul
A
A
Yates
P J
PJ
Elwell
R
R
Nicholson
M L
ML
D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery / Q000033:anatomy & histology*; D012079:Renal Circulation; D012082:Renal Veins / Q000033:anatomy & histology*; D012449:Safety; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000592:standards