Use of the Satinsky clamp for hilar clamping during robotic partial nephrectomy: indications, technique, and multi-center outcomes

Newaj Abdullah; Haider Rahbar; Ravi Barod; Deepansh Dalela; Jeff Larson; Michael Johnson; Alon Mass; Homayoun Zargar; Jihad Kaouk; Mohamad Allaf; Sam Bhayani; Michael Stifelman; Craig Rogers

doi:10.1007/s11701-016-0611-y

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Use of the Satinsky clamp for hilar clamping during robotic partial nephrectomy: indications, technique, and multi-center outcomes

Journal article

Peer reviewed

Use of the Satinsky clamp for hilar clamping during robotic partial nephrectomy: indications, technique, and multi-center outcomes

Newaj Abdullah, Haider Rahbar, Ravi Barod, Deepansh Dalela, Jeff Larson, Michael Johnson, Alon Mass, Homayoun Zargar, Jihad Kaouk, Mohamad Allaf, …

Journal of robotic surgery, Vol.11(1), pp.47-51

03/2017

DOI: 10.1007/s11701-016-0611-y

PMID: 27329237

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Abstract

A Satinsky clamp may be a backup option for hilar clamping during robotic partial nephrectomy (RPN) if there are challenges with application of bulldog clamps, but there are potential safety concerns. We evaluate outcomes of RPN using Satinsky vs. bulldog clamps, and provide tips for safe use of the Satinsky as a backup option. Using a multi-center database, we identified 1073 patients who underwent RPN between 2006 and 2013, and had information available about method of hilar clamping (bulldog clamp vs. Satinsky clamp). Patient baseline characteristics, tumor features, and perioperative outcomes were compared between the Satinsky and bulldog clamp groups. A Satinsky clamp was used for hilar clamping in 94 (8.8 %) RPN cases, and bulldog clamps were used in 979 (91.2 %) cases. The use of a Satinsky clamp was associated with greater operative time (198 vs. 175 min, p < 0.001), estimated blood loss (EBL, 200 vs. 100 ml, p < 0.001), warm ischemia time (WIT, 20 vs. 19 min, p = 0.036), transfusion rate (12.8 vs. 4.8 %, p = 0.001), and hospital stay (3 vs. 2 days, p < 0.001). Tumor characteristics and number of renal vessels were similar between groups. There were six intraoperative complications in the Satinsky clamp group, but none were directly related to the Satinsky clamp. On multivariable analysis, the use of the Satinsky clamp was not associated with increase in intraoperative or Clavien ≥3 postoperative complications, positive surgical margin rate or percentage change in estimated glomerular filtration rate. A Satinsky clamp can be a backup option for hilar clamping during challenging RPN cases, but requires careful technique, and was rarely necessary.

Aged

Blood Loss, Surgical - statistics & numerical data

Female

Humans

Kidney Neoplasms - surgery

Length of Stay - statistics & numerical data

Male

Middle Aged

Nephrectomy - adverse effects

Nephrectomy - instrumentation

Nephrectomy - methods

Operative Time

Postoperative Complications - etiology

Retrospective Studies

Robotic Surgical Procedures - adverse effects

Robotic Surgical Procedures - instrumentation

Robotic Surgical Procedures - methods

Surgical Instruments - adverse effects

Warm Ischemia - statistics & numerical data

Details

Title: Subtitle: Use of the Satinsky clamp for hilar clamping during robotic partial nephrectomy: indications, technique, and multi-center outcomes
Creators: Newaj Abdullah - Henry Ford Health System
Haider Rahbar - Henry Ford Health System
Ravi Barod - Henry Ford Health System
Deepansh Dalela - Henry Ford Health System
Jeff Larson - Washington University in St. Louis
Michael Johnson - University of Baltimore
Alon Mass - New York University
Homayoun Zargar - Cleveland Clinic
Jihad Kaouk - Cleveland Clinic
Mohamad Allaf - University of Baltimore
Sam Bhayani - Washington University in St. Louis
Michael Stifelman - New York University
Craig Rogers - Henry Ford Health System
Resource Type: Journal article
Publication Details: Journal of robotic surgery, Vol.11(1), pp.47-51
DOI: 10.1007/s11701-016-0611-y
PMID: 27329237
NLM abbreviation: J Robot Surg
ISSN: 1863-2483
eISSN: 1863-2491
Language: English
Date published: 03/2017
Academic Unit: Urology
Record Identifier: 9984949462302771

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