www.kjurology.org http://dx.doi.org/10.4111/kju.2011.52.8.543 Endourology A Feasible Technique for Transient Vascular Occlusion by Using a Vessel Loop and Hem-o-Lok Clips in Laparoscopic Partial Nephrectomy Yoon Hyung Lee, Joon Beom Kwon, Sung Ryong Cho, Jae Soo Kim Department of Urology, Daegu Fatima Hospital, Daegu, Korea Purpose: We introduce our transient vascular occlusion technique that uses a vessel loop and Hem-o-Lok clips in laparoscopic partial nephrectomy. Materials and Methods: From March 2009 to March 2011, 15 consecutive patients un- derwent laparoscopic partial nephrectomy. All operations were performed by a single surgeon using the transperitoneal approach. The transient vascular occlusion techni- que was as follows. After dissection of renal vessels, the vessel loop is winded twice around the vessel. Both distal portions of the vessel loop are clipped with a Hem-o-Lok clip. When vascular occlusion is required, an additional Hem-o-Lok clip is applied to the proximal portion of the vessel loop by pulling the distal portion. When no longer needed, the vessel loop is simply cut. Results: All operations were performed successfully without open conversion. The mean tumor size was 2.5 cm (range, 1.1-3.5 cm). There were 8 cases of renal cell carcinoma and 7 cases of angiomyolipoma. All cases of renal cell carcinoma had a negative surgical margin. The mean operative time and the mean warm ischemic time were 176 minutes (range, 104-283 minutes) and 26.1 minutes (range, 18-34 minutes), respectively. There were no cases of uncontrollable intraoperative bleeding and no postoperative complications. Conclusions: The transient vascular occlusion technique with a vessel loop and Hem-o-Lok clips is a feasible technique with simplicity, effectiveness, and safety. It is an acceptable alternative to standard vascular occlusion techniques, such as laparo- scopic bulldog or Satinsky clamps. Key Words: Kidney neoplasms; Laparoscopy; Nephrectomy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Article History: received 7 May, 2011 accepted 15 July, 2011 Corresponding Author: Jae Soo Kim Department of Urology, Daegu Fatima Hospital, 183, Ayang-ro, Dong-gu, Daegu 701-600, Korea TEL: +82-53-940-7152 FAX: +82-53-954-7417 E-mail: mdkjs99@hanmail.net INTRODUCTION Due to the increased use of imaging modalities, the in- cidence of incidental renal cell carcinoma has increased [1]. Surgical resection remains the gold standard treatment for renal cell carcinoma but is no longer limited to open radical nephrectomy. Partial nephrectomy has emerged as the standard treatment for small renal tumors, particularly in cases with imperative indications [2]. During the past dec- ade, technical refinements have resulted in laparoscopic partial nephrectomy (LPN) being equivalent to open sur- gery in terms of oncologic outcomes, perioperative compli- Korean Journal of Urology Ⓒ The Korean Urological Association, 2011 cations, and renal function [3,4]. 　Transient vascular occlusion is an important surgical step in LPN to facilitate tumor excision and decrease blood loss. Laparoscopic bulldog or Satinsky clamps are tools widely used around the world to achieve renal pedicle clamping. The vessel loop and Hem-o-lokTM clip system (Weck Closure Systems, Research Triangle Pack, NC, USA) has been reported to make it possible to clamp renal vessels transiently during LPN [5,6]. Here we report an- other feasible technique for achieving transient vascular occlusion by using a vessel loop and Hem-o-lok clips during LPN. 543 Korean J Urol 2011;52:543-547