INTRODUCTION: The technique used to control and divide the renal vessels during laparoscopic nephrectomy is critical to successful surgical outcomes. The aim of this study was to compare renal pedicle vessel control using (1) Hem-o-lok clips with a LigaSure vessel sealing system, and (2) Hem-o-lok clips without LigaSure.
METHODS: A total of 20 patients underwent unilateral transperitoneal laparoscopic nephrectomy between February 2007 and February 2008. They were divided nonrandomly into 2 groups. Group 1 (n = 10) underwent laparoscopic nephrectomy using Hem-o-lok clips and the Valleylab LigaSureâ„¢ vessel sealing system; group 2 (n = 10) underwent laparoscopic nephrectomy using Hem-o-lok clips without LigaSure. Outcome variables were compared across groups using Mann-Whitney tests.
RESULTS: The mean operative time was significantly shorter for patients in group 1 (P < .0001). Clip time was significantly shorter for patients in group 1 (P < .0001). Transection time was significantly shorter for patients in group 2 (P < .0001). There were no significant group differences in total pedicle dissection time (P > .05). Subcutaneous emphysema and intraabdominal adherence were the only complications recorded, and there were no significant group differences in their occurrence. There was no conversion to open surgery in either group. There was no significant group difference in mean length of hospitalization.
CONCLUSION: Results of the present study showed that using the LigaSure vessel sealing system for laparoscopic nephrectomy can decrease operative time. The shorter operative time is attributed to easier control of bleeding and a reduced number of instrument exchanges when using the LigaSure device.
Siavash Falahatkar
KEYWORDS: LigaSure; Laparoscopic nephrectomy; Renal pedicle control; Hem-o-lok clip
CORRESPONDENCE: Siavash Falahatkar M.D., Guilan University of Medical Sciences, Urology Research Center, Razi Hospital, Sardare Jangal Street, Rasht, Guilan 41448, Iran ( ).
CITATION: Urotoday Int J. 2010 Apr;3(2).
doi: 10.3834/uij.1944-5784.2010.04.10