title: Experience of laparoscopic partial nephrectomy using a kidney grasper in selective cases.
abstract: OBJECTIVE
  To evaluate the feasibility of regional cramp in laparoscopic partial nephrectomy, we performed partial nephrectomy using a kidney grasper that enabled the application of ischemia to a limited region of the kidney.
  
  
  METHODS
  The subjects were 5 renal cell carcinoma patients. The mean tumor diameter was 15 mm. There were 2 male and 3 female patients. A transperitoneal approach was used in all cases. Following the standard procedure of laparoscopic partial resection, the hilum of the kidney was confirmed and treated to prepare for rapidly applying clamping with forceps. Tumor resection and suture were then performed under partial warm ischemia using a kidney grasper.
  
  
  RESULTS
  Surgery could be completed in 4 patients using this method. In the remaining patient, control of bleeding was considered difficult during tumor resection after applying partial ischemia, and so the procedure was switched to renal artery clamping using bulldog forceps. In the 4 patients in whom a kidney grasper was used, the mean partial warm ischemia time was 23.6 minutes (range, 23-25 minutes), and the mean blood loss was 110 mL (range, 20-260 mL).
  
  
  CONCLUSIONS
  This procedure may be a useful option in ischemia for partial nephrectomy.
authors.affiliation: 1 Department of Urology, Kyoto Prefectural University of Medicine , Kyoto, Japan .
authors.forename: Fumiya
authors.initials: F
authors.lastname: Hongo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.forename: Yoshizo
authors.initials: Y
authors.lastname: Itoh
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Fujii
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.forename: Terukazu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naya
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kamoi
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003250:Constriction; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D052096:Warm Ischemia / Q000379:methods