Efficacy of the intracorporeal one-hand tie technique for renal pedicle control during hand-assisted retroperitoneoscopic nephroureterectomy

ObjectiveThis study examined the efficacy of the intracorporeal one-hand tie technique for renal pedicle control during hand-assisted retroperitoneoscopic nephroureterectomy (HARN).MethodsThe intracorporeal one-hand tie technique was conducted in 32 consecutive patients with upper tract urothelial cancer that underwent HARN and open bladder cuff excision.ResultsAll suture ligatures were successful in securing the renal vessels, except one minor venous bleeding that occurred during vessel transection, which was then controlled by additional clips. The process of controlling the renal pedicle took an average of 12.4 minutes (range, 8–30 minutes). No pedicle control related morbidities were noted. By sparing the usage of endovascular clips and staplers, operative costs were reduced and associated malfunctions eliminated.ConclusionThe intracorporeal one-hand tie technique is an easy, reliable, and cost-effective method in controlling the renal pedicle during HARN. Its efficacy in pedicle control is beyond doubt.