title: The Application of Hem-O-Lok Clips Tied with Threads to Improve Surgical View in Retroperitoneal Laparoscopic Surgery for Renal Cell Carcinoma.
abstract: OBJECTIVE
  To evaluate the feasibility of Hem-o-lok clips tied with threads to improve surgical view in retroperitoneal laparoscopic surgery for renal cell carcinoma.
  
  
  METHODS
  Laparoscopic radical and partial nephrectomies performed by a single surgeon from May 2013 to April 2015 were reviewed. If Hem-o-lok clips tied with threads were applied to improve surgical view, the patient was recruited to the Hem-o-lok group. The other patients were recruited to the control group. Patient information, time of exposure procedure, number of clips used, number of trocars, exposure satisfaction, operation time, estimated blood loss, and perioperative complications were recorded.
  
  
  RESULTS
  Sixty-eight laparoscopic radical/partial nephrectomies were performed by a single surgeon. For 31 cases, Hem-o-lok clips were tied with threads to improve surgical view. For the other 37 cases, no Hem-o-lok clips were used. All cases were successfully performed. It took 30 to 178 seconds to finish the exposure procedure. In the Hem-o-lok group, less trocar usage, shorter operation time, and better exposure satisfaction were observed than control group (P < .05).
  
  
  CONCLUSIONS
  This new technique is feasible and easy to improve surgical view in retroperitoneal laparoscopic surgery for renal cell carcinoma. This technique may be helpful to shorten operation time and avoid the use of the fourth trocar in certain cases. Large scale randomized controlled studies are needed to further prove its efficiency.
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Chao
authors: C
authors: Zhang
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Fei
authors: F
authors: Guo
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Huiqing
authors: H
authors: Wang
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Chen
authors: C
authors: Ye
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Zhensheng
authors: Z
authors: Zhang
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Bo
authors: B
authors: Yang
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Chuanliang
authors: C
authors: Xu
authors: Department of Urology, Changhai Hospital, The Second Military Medical University , Shanghai, China .
authors: Yinghao
authors: Y
authors: Sun
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012187:Retroperitoneal Space / Q000601:surgery*; D013525:Surgical Instruments; D013536:Suture Techniques
keywords: partial nephrectomy; renal cell carcinoma; retroperitoneal laparoscopic surgery; surgical view