Application of the Hem-o-lok ligation system in laparoscopic nephrectomy.
BACKGROUND
The Hem-o-lok polymer clip has become the preferred method to control large vessels during operation. We explored the advantages of application of the Hem-o-lok ligation system in laparoscopic nephrectomy.


METHODS
From January 2004 to May 2009, 116 laparoscopic nephrectomies were performed using Hem-o-lok clips to control renal artery and vein, including 22 simple nephrectomies, 63 radical nephrectomies, and 31 nephroureterectomies. Operative time, estimated intraoperative blood loss, recovery time of intestinal function, postoperative hospital day, as well as complication rate were recorded and studied retrospectively. The number and cost of Hem-o-lok clips were analyzed.


RESULTS
All 116 laparoscopic nephrectomies using Hem-o-lok clips for renal pedicle control were accomplished successfully without conversion to open surgery. No intra/postoperative vascular complications or other clip-related complications occurred. Laparoscopic operating time was 14-275 min (average 146.5 min). Estimated blood loss was 25-600 ml (average 159.2 ml). Mean recovery time of intestinal function was 30.4 h (range 16-72 h). Postoperative hospital stay was 4-22 days, with an average of 7.3 days. The mean number of Hem-o-lok clip used per operation was 5.3 (range 4-8).


CONCLUSIONS
Use of the Hem-o-lok ligation system to control renal pedicle is safe and reliable for laparoscopic simple/radical nephrectomy.
Ping
Hao
H
Department of Urology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020, People's Republic of China. pinghaozx@yahoo.com.cn
Xing
Nian-Zeng
NZ
Zhang
Jun-Hui
JH
Yan
Yong
Y
Kang
Ning
N
Niu
Yi-Nong
YN
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000295:instrumentation; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery; D012082:Renal Veins; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome