Use of bipolar electrocautery during laparoscopic donor nephrectomy

Purpose: We describe a technique enabling easier placement of the endoscopi c linear stapling device on the renal vein during laparoscopic nephrectomy. Materials and Methods: Bipolar electrocautery rather than a clip applier wa s used in 20 laparoscopic donor nephrectomy cases to coagulate the renal ve in branches before transection. Warm ischemia time of the specimens and the number of surgical clip applier devices used were compared with those in t he 20 immediate preceding cases in which bipolar electrocautery was not use d. Results: Using bipolar electrocautery no clips were placed on the specimen side of the renal vein before stapling. Average warm ischemia time for the 20 kidneys in which bipolar electrocautery was performed was 2 minutes 13 s econds compared with 3 minutes 1 second far the previous 20 (p = 0.157). Si gnificantly fewer clip applying devices were used in the 20 bipolar electro cautery cases (p = 0.005). Conclusions: Bipolar electrocautery of the renal vein branches enables easi er placement of the endoscopic linear stapling device on the renal vein and the use of fewer surgical clip appliers during laparoscopic surgery. Becau se the bipolar electrocautery device is reusable, it decreases operative co sts.