RESUMEN
The hem-o-lock is useful tools for the laparoscopic surgeon. We herein describe a simplified technique for suturing and knotting technique using hem-o-loc. After enucleation of the myoma, uterine parenchymal defect was closed laparoscopically using a 1-0 vicryl suture on a needle, also prepared with a hem-o-lock. Before suturing, the vicryl is tied up with hem-o-loc on the tail of continuous suture that is start point of suture site. Once the suture is passed, a hem-o-loc is used to cinch it down on the suture site and secure the knot tightly. All sutures can be completed with just one suture, continuously. We experienced no major surgical complication.
Asunto(s)
Mioma , Agujas , Poliglactina 910 , SuturasRESUMEN
Objective To analyze the clinical techniques of renal artery control in laparoscopic donor nephrectomy.Methods 211 relative living renal transplantations were performed from June 2003 to June 2012,and 136 donors underwent laparoscopic donor living nephrectomy (LDN) since 2007.Forty donors were subjected to the Hem-o-lock clips for renal artery control by open surgery,87 donors to the Hem-o-lock clips for renal artery control by laparoscope,5 donors to the Endo GIA stapler for renal artery control by laparoscope,and 4 donors to the Hem-o-lock clips by laparoscope combined with hand-assisted suture transfixion for renal artery control.Results The warm ischemia time of renal artery control was shortest (1.1 ± 0.3 min) by Hem-o-lock clips in open surgery,and longest (3.2 ± 0.8) min by the Hem-o-lock clips with laparoscope.There was significant difference in the warm ischemia time of renal artery between open group and other groups,the differences (P＜0.05).The comparison of prognostic factors in the transplant renal outcome showed no significant difference among groups.The renal arterial stump-rrhexis-caused massive secondary bleeding occurred in 1 case subject to Hem-o-lock clips for renal artery control by laparoscope,with conversion to open surgery urgently,the operation was successful at last.Other renal artery control ways were all safe without any adverse reaction.Conclusion The warm ischemia time of renal artery control by Hem-o-lock clips in open surgery was shortest in laparoscopic donor nephrectomy.The renal artery control way by Endo GIA stapler in laparoscope or by Hem-o-lock clips with hand-assisted suture transfixion is safest.The utilization of Hem-o-lock clips should be careful in high risk population such as severe atherosclerosis etc.