Laparoscopic off-clamp partial nephrectomy using soft coagulation

ObjectivesTo assess the effectiveness of soft coagulation in off-clamp laparoscopic partial nephrectomy. MethodsA total of 32 patients with renal tumors underwent laparoscopic partial nephrectomy with off-clamp using soft coagulation between May 2012 and September 2013. Tumor resection was carried out using a combination of bipolar forceps and a ball electrode using the soft coagulation system without hilar clamping. The outcomes of these patients were compared with those of 30 patients treated with hilar clamping. ResultsThis off-clamp procedure was successfully completed in 31 cases. No significant differences were observed in the mean age (60 vs 61years), sex (male/female; 25/7 vs 20/10), mean RENAL nephrometry score (5.7 vs 5.8), mean body mass index (24.4 vs 23) or tumor size (15mm vs 16mm) between the two groups. No significant differences were noted in positive surgical margins (0 vs 0) or blood loss (104 vs 115cc) as well. In contrast, a significant difference was noted in the total operative time (278 vs 238min). Serum creatinine percentage changes at 3months were 6.4 versus 7.3% in the off-clamp and hilum-clamp groups, respectively, which were not significantly different. ConclusionsOff-clamp laparoscopic partial nephrectomy can be safely carried out by using a soft coagulation technique.