Laparoscopic techniques applied to open surgery: Sliding-clip renorrhaphy

Objectives To describe our initial experience with the laparoscopic technique of sliding-clip renorrhaphy applied to open surgery for small renal masses. Methods Knotless renorrhaphy with the sliding-clip technique is performed by securing suture with Hem-o-lok clips slid under tension against the renal capsule and locked in place with Lapra-Ty clips. This approach was initially described by laparoscopic surgeons to aid with hemostasis, prevent urine leaks, and shorten warm ischemia time. We evaluated the utility of this technique during open partial nephrectomy. Results From February 2009 to June 2010, 9 patients, with mean age of 54 years, underwent open partial nephrectomy using the sliding-clip technique. Mean ischemia time was <20 minutes, with a mean blood loss of approximately 280 mL. No intraoperative complications were reported. One clinically significant complication of a urinoma was found in the perioperative period. No bleeding complications developed. Conclusions The results of our study have shown that the sliding-clip technique is safe and effective in the open surgical management of small renal masses. We recommend this approach over traditional knot tying for renal reconstruction.