Total clipless laparoscopic nephrectomy carried out with the LigaSure device: Preliminary experience

• Published in: Progrès en urologie (Paris) Vol. 33; no. 6; p. 344
• Main Authors: Saouli, Amine, Karmouni, Tarik, El Khader, Khalid, Koutani, Abdellatif, Attya Andaloussi, Ahmed Iben
• Format: Journal Article
• Language: English
• Published: France 01-05-2023
• Subjects: Blood Loss, Surgical; Humans; Kidney; Laparoscopy - methods; Nephrectomy - methods; Pyelonephritis; Retrospective Studies; Laparoscopie; Nephrectomy; Non functional; Néphrectomie; Hemostatic techniques; Non fonctionnel; Laparoscopy; Techniques hémostatiques; Kidney; Rein
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2023.03.006

Total laparoscopic nephrectomy has become the standard method for the removal of diseased kidneys.
The purpose of this study was to evaluate the feasibility of the LigaSure vessel closure system during laparoscopic nephrectomy.
From January 2018 to June 2018, the LigaSure device was used in 5 patients undergoing laparoscopic nephrectomy for non functional kidney. Nephrectomy was carried out without the use of clips or sutures for vessel closure. We report intraoperative findings, conversion rates, blood loss, operative time, morbidity, and postoperative outcomes.
Median operative time was 45minutes (range 25 to 60min). Median blood loss was 30mL (range 10 to 50mL). No conversions to open surgery were necessary. No patients experienced major bleeding intraoperatively or postoperatively. All patients left the hospital one day after the procedure. Histopathological examination of the removed kidneys was in favor of chronic non specific pyelonephritis.
For the treatment of the renal pedicle during total laparoscopic nephrectomy of a destroyed kidney, the LigaSure device appears to be feasible and effective. Our experience is the first to demonstrate the advantages of LigaSure® in laparoscopic nephrectomy: reduction in operating time, blood loss, transfusions and length of stay in hospital.