title: Running-clip renorrhaphy reducing warm ischemic time during laparoscopic partial nephrectomy.
abstract: OBJECTIVE
  In this study, we report a simple closure technique of the renal parenchyma using a knotless running suture with Hem-o-lok(®) (Teleflex(®) Medical, Research Triangle Park, NC) clips (running-clip renorrhaphy) to minimize warm ischemic time (WIT) and reduce intraoperative blood loss (IBL).
  
  
  METHODS
  From 2008 to 2010, laparoscopic partial nephrectomy (LPN) was performed by traditional interrupted knot-tying suture renorrhaphy (Group I; n=28). Since then, from 2011 to 2013, LPN was performed by running-clip technique renorrhaphy (Group II; n=51). A comparative analysis of WIT and IBL between Groups I and II patients was investigated.
  
  
  RESULTS
  All the LPNs were performed successfully without open conversion. No significant differences were observed for patients of different ages, body mass indexes, and preoperative estimated glomerular filtration rates. In Group I, the operative time, WIT, and IBL were 170.0±27.0 minutes, 32.3±6.5 minutes, and 369±201 mL, respectively. In Group II, the operative time, WIT, and IBL were 148.7±31.9 minutes, 21.5±5.8 minutes, and 254±162 mL, respectively. There was significant difference in operative time, WIT, and IBL between Groups I and II (P=.004, .001, and .008, respectively).
  
  
  CONCLUSIONS
  The running-clip renorrhaphy reduced operative time, WIT, and IBL during the LPN. Therefore, running-clip renorrhaphy is a safe, efficient, and operative technique for performing the LPN.
authors.affiliation: Department of Urology, The Catholic University of Korea College of Medicine , Seoul, Korea.
authors.forename: Kang Sup
authors.initials: KS
authors.lastname: Kim
authors.forename: Sae Woong
authors.initials: SW
authors.lastname: Choi
authors.forename: Jeong Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Woong Jin
authors.initials: WJ
authors.lastname: Bae
authors.forename: Hyuk Jin
authors.initials: HJ
authors.lastname: Cho
authors.forename: Ji Youl
authors.initials: JY
authors.lastname: Lee
authors.forename: Sae Woong
authors.initials: SW
authors.lastname: Kim
authors.forename: Tae-Kon
authors.initials: TK
authors.lastname: Hwang
authors.forename: Sung-Hoo
authors.initials: SH
authors.lastname: Hong
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D011866:Radioisotope Renography / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D052096:Warm Ischemia / Q000009:adverse effects*