Department of Urology, Affiliated Beijing Chaoyang Hospital of
Capital Medical University, Beijing, China
Introduction: To describe a clamping technique of renal arterial
branches during laparoscopic nephron-sparing surgery (LNSS)
using the laparoscopic ultrasonography.
Methods: Between March and November 2011, thirty patients
(20 males and 10 females) with small renal mass (SRM)
were planed to underwent LNSS at our institution with
highly selective clamping of renal arterial branches using the
laparoscopic ultrasonography. The laparoscopic ultrasonography
was used to detect the location, size, and blood supply (before
and after clamping) of the tumor. The perioperative data of all
surgeries were presented.
Results: LNSS was successfully performed in twenty-nine
patients. Two cases required conversion to clamping the main
renal artery because of intraoperative bleeding. The mean
operative time was 130 min (range, 100-210), mean estimated
blood loss was 120 mL (range, 30-400), mean time for the
clamping of renal arterial branches was 28 min (range, 15-
36). There was no blood transfusion or conversion to open
surgery. The mean stay of drainage tube was 5 days. The mean
postoperative hospital stay was 7 days. sCr and eGFR were
not significant different between pre- and post-operation. The
recovery of all patients was uneventful.
Conclusions: Highly selective clamping of renal arterial
branches is a new technique to protect renal function in
LNSS, which can be performed safely and efficiently with a
combination of the laparoscopic ultrasonography. Further
studies and longer follow-up are necessary to determine the
long-term efficacy of this novel technique.