title: 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.
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.
authors: Universitatsklinik fur Urologie, Medizinische Universitat Innsbruck, Innsbruck, Tirol, Austria. ho.henry.s.s@gmail.com
authors: Henry Sun Sien
authors: HS
authors: Ho
authors: Reinhard
authors: R
authors: Peschel
authors: Richard
authors: R
authors: Neururer
authors: Hannes
authors: H
authors: Steiner
authors: Christian
authors: C
authors: Schwentner
authors: Georg
authors: G
authors: Bartsch
mesh_terms: D000368:Aged; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D012371:Robotics / Q000379:methods*; D013525:Surgical Instruments