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Ureteral Clipping Simplifies Hand-Assisted Laparoscopic Donor Nephrectomy
Authors:James A. Brown   Kamran P. Sajadi   James J. Wynn
Abstract:

Objectives:

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.

Methods:

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.

Results:

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.

Conclusion:

Distal ureter clipping to prevent urine accumulation around the renal hilum during HALDN is safe and helpful.
Keywords:Nephrectomy   Donor   Laparoscopy   Ureter
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