Skip to main content
SpringerLink
Log in

Renal artery clip dislodgement during hand-assisted laparoscopic living donor nephrectomy

  • Case report
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

The main reason for conversion in laparoscopic donor nephrectomy (LDN) is peroperative bleeding. One of the advantages of hand-assisted laparoscopic donor nephrectomy (HDLN) is facilitated control in case of bleeding. This report describes two methods to avert conversion in HLDN in the case of abrupt major arterial bleeding. In the first case, during left HLDN the clips placed on the renal artery dislodged, and the surgeon managed to control the bleeding by compressing the focus of the bleeding with his finger. A balloon occlusion catheter was inserted through a groin incision in the aorta and advanced to the origo of the renal artery. Due to control of the hemorrhage, it was possible to close the renal artery stump by laparoscopic suturing, and a conversion was averted. The patient was discharged after 5 days, without signs of damage to the remaining kidney. In the second case, during right HLDN, the clips on the renal artery dislodged during stapling of the renal vein. The bleeding was controlled by finger compression and new clips were placed. The cuff of the artery was long enough to be clipped again. The patient was discharged after 5 days. Graft function was excellent in both cases. Major arterial bleeding can be controlled and managed in hand-assisted laparoscopic surgery. The use of a balloon occlusion catheter is an elegant way to avert conversion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. WA Bemelman RC van Doorn LT de Wit C Kox J Surachno OR Busch DJ Gouma (2001) ArticleTitleHand-assisted laparoscopic donor nephrectomy. Ascending the learning curve. Surg Endosc 15 442–444 Occurrence Handle10.1007/s004640090091 Occurrence Handle1:STN:280:DC%2BD3M3mtl2htQ%3D%3D Occurrence Handle11353956

    Article  CAS  PubMed  Google Scholar 

  2. JF Buell J Alverdy KA Newell A Yoshida S Limsrichamrern ES Woodle DS Bruce (2001) ArticleTitleHand-assisted laparoscopic live-donor nephrectomy. J Am Coll Surg 192 132–136 Occurrence Handle10.1016/S1072-7515(00)00742-0 Occurrence Handle1:STN:280:DC%2BD3M%2FpsVyhtw%3D%3D Occurrence Handle11192915

    Article  CAS  PubMed  Google Scholar 

  3. MS Dunker WA Bemelman JF Slors P van Duijvendijk DJ Gouma (2001) ArticleTitleFunctional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. Dis Colon Rectum 44 1800–1807 Occurrence Handle1:STN:280:DC%2BD3MjgtV2jug%3D%3D Occurrence Handle11742165

    CAS  PubMed  Google Scholar 

  4. JL Flowers S Jacobs E Cho A Morton WF Rosenberger D Evans AL Imbembo ST Bartlett (1997) ArticleTitleComparison of open and laparoscopic live donor nephrectomy. Ann Surg 226 483–489 Occurrence Handle1:STN:280:DyaK1c%2Fht1Srsw%3D%3D Occurrence Handle9351716

    CAS  PubMed  Google Scholar 

  5. SC Jacobs E Cho BJ Dunkin JL Flowers E Schweitzer C Cangro J Fink A Farney B Philosophe B Jarrell ST Bartlett (2000) ArticleTitleLaparoscopic live donor nephrectomy: the University of Maryland 3-year experience. J Urol 164 1494–1499 Occurrence Handle1:STN:280:DC%2BD3M%2FjtFGktw%3D%3D Occurrence Handle11025690

    CAS  PubMed  Google Scholar 

  6. K Kercher D Dahl R Harland R Blute K Gallagher D Litwin (2001) ArticleTitleHand-assisted laparoscopic donor nephrectomy minimizes warm ischemia. Urology 58 152–156 Occurrence Handle10.1016/S0090-4295(01)01194-3 Occurrence Handle1:STN:280:DC%2BD3MvksVeksw%3D%3D Occurrence Handle11489685

    Article  CAS  PubMed  Google Scholar 

  7. MY Lind EJ Hazebroek WC Hop W Weimar BH Jaap JN Ifjzermans (2002) ArticleTitleRight-sided laparoscopic live-donor nephrectomy: is reluctance still justified? Transplantation 74 1045–1048 Occurrence Handle12394852

    PubMed  Google Scholar 

  8. P Lindstrom M Haggman J Wadstrom (2002) ArticleTitleHand-assisted laparoscopic surgery (HALS) for live donor nephrectomy is more. Surg Endosc 16 422–425 Occurrence Handle10.1007/s00464-001-9120-8 Occurrence Handle1:STN:280:DC%2BD387psFSitA%3D%3D Occurrence Handle11928020

    Article  CAS  PubMed  Google Scholar 

  9. DE Litwin A Darzi J Jakimowicz JJ Kelly D Arvidsson P Hansen MP Callery R Denis DL Fowler DS Medich MJ O’Reilly H Atlas JM Himpens LL Swanstrom EJ Arous P Pattyn SM Yood R Ricciardi A Sandor WC Meyers (2000) ArticleTitleHand-assisted laparoscopic surgery (HALS) with the HandPort system: initial experience with 68 patients. Ann Surg 231 715–723 Occurrence Handle1:STN:280:DC%2BD3c3jtFCksQ%3D%3D Occurrence Handle10767793

    CAS  PubMed  Google Scholar 

  10. RW Luijendijk J Jeekel RK Storm PJ Schutte WC Hop AC Drogendijk FJ Huikeshoven (1997) ArticleTitleThe low transverse Pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment. Ann Surg 225 365–369 Occurrence Handle10.1097/00000658-199704000-00004 Occurrence Handle1:STN:280:ByiB28bovFI%3D Occurrence Handle9114794

    Article  CAS  PubMed  Google Scholar 

  11. MD Odlahd AL Ney DM Jacobs JA Larkin EK Steffens JJ Kraatz JL Rodriguez (1999) ArticleTitleInitial experience with laparoscopic live donor nephrectomy. Surgery 126 603–606 Occurrence Handle10.1067/msy.2099.100720 Occurrence Handle10520904

    Article  PubMed  Google Scholar 

  12. LE Ratner LR Kavoussi M Sroka J Hiller R Weber PG Schulam R Montgomery (1997) ArticleTitleLaparoscopic assisted live donor nephrectomy—a comparison with the open approach. Transplantation 63 229–233 Occurrence Handle1:STN:280:ByiC2s3itlw%3D Occurrence Handle9020322

    CAS  PubMed  Google Scholar 

  13. G Ruiz-Deya S Cheng E Palmer R Thomas D Slakey (2001) ArticleTitleOpen donor, laparoscopic donor and hand assisted laparoscopic donor nephrectomy: a comparison of outcomes. J Urol 166 1270–1274 Occurrence Handle1:STN:280:DC%2BD3MvpvVartA%3D%3D Occurrence Handle11547056

    CAS  PubMed  Google Scholar 

  14. TM Sasaki F Finelli E Bugarin D Fowlkes J Trollinger DY Barhyte JA Light (2000) ArticleTitleIs laparoscopic donor nephrectomy the new criterion standard? Arcr Surg 135 943–947 Occurrence Handle10.1001/archsurg.135.8.943 Occurrence Handle1:STN:280:DC%2BD3cvhs12rtg%3D%3D

    Article  CAS  Google Scholar 

  15. MD Stifelman D Hull RE Sosa LM Su M Hyman W Stubenbord S Shichman (2001) ArticleTitleHand assisted laparoscopic donor nephrectomy: a comparison with the open approach. J Urol 166 444–448 Occurrence Handle1:STN:280:DC%2BD3MvgslOrug%3D%3D Occurrence Handle11458044

    CAS  PubMed  Google Scholar 

  16. E Velidedeoglu N Williams KL Brayman NM Desai L Campos M Palanjian M Wocjik R Bloom RA Grossman K Mange CF Barker A Naji JF Markmann (2002) ArticleTitleComparison of open, laparoscopic, and hand-assisted approaches to live-donor nephrectomy. Transplantation 74 169–172 Occurrence Handle12151727

    PubMed  Google Scholar 

  17. JS Wolf Jr RM Merion AB Leichtman DA Campbell Jr JC Magee JD Punch JG Turcotte JW Konnak (2001) ArticleTitleRandomized controlled trial of hand-assisted laparoscopic versus open surgical live donor nephrectomy. Transplantation 72 284–290 Occurrence Handle1:STN:280:DC%2BD3MvktFWisQ%3D%3D Occurrence Handle11477354

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Academic Medical Center, Meibergdreef 9, 1100DD Amsterdam, The Netherlands

    S. Maartense, R. J. Heintjes, M. Idu & W. A. Bemelman

  2. Department of Nephrology, Academic Medical Center, Meibergdreef 9, 1100DD Amsterdam, The Netherlands

    F. J. Bemelman

Authors
  1. S. Maartense
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. J. Heintjes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Idu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. J. Bemelman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W. A. Bemelman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. A. Bemelman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maartense, S., Heintjes, R., Idu, M. et al. Renal artery clip dislodgement during hand-assisted laparoscopic living donor nephrectomy . Surg Endosc 17, 1851 (2003). https://doi.org/10.1007/s00464-003-4230-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-4230-0

Keywords

Search

Navigation