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Ureteral clipping simplifies hand-assisted laparoscopic donor nephrectomy
Journal article   Open access

Ureteral clipping simplifies hand-assisted laparoscopic donor nephrectomy

James A Brown, Kamran P Sajadi and James J Wynn
Journal of the Society of Laparoendoscopic Surgeons, Vol.14(4), pp.531-533
10/2010
DOI: 10.4293/108680810X12924466008042
PMCID: PMC3083044
PMID: 21605517
url
https://doi.org/10.4293/108680810X12924466008042View
Published (Version of record) Open Access

Abstract

We describe a technique of doubly clipping the distal ureter during hand-assisted laparoscopic donor nephrectomy (HALDN) to prevent urine accumulation, thereby simplifying renal hilar division and potentially decreasing the graft warm ischemic time. A technique of placing polymer-locking clips across the distal ureter prior to division was developed to prevent urine accumulation and the need for suctioning during critical hilar vessel division. We found that ureteral clipping and the elimination of urine accumulation simplified renal hilar division. Retrospective assessment of a series of 27 sequential HALDNs (15 without and 12 with clipping) demonstrated similar estimated blood loss, total operative and warm ischemic times (P 0.13 to 0.18). No adverse impact on graft viability or recipient outcome was observed. Distal ureter clipping to prevent urine accumulation around the renal hilum during HALDN is safe and helpful.
 Length of Stay Urodynamics Suture Techniques - instrumentation Humans Treatment Outcome Living Donors Retrospective Studies Ureter - surgery Equipment Design Kidney Transplantation - methods Nephrectomy - methods Hand-Assisted Laparoscopy - methods

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