[Preliminary application of monopolar coagulation in suturelesslaparoscopic partial nephrectomy].

Objective: To study the safety and feasibility of using monopolar coagulation in sutureless laparoscopic partial nephrectomy (LPN). Methods: From February 2015 to March 2016, sutureless LPN using monopolar coagulation was performed on 25 patients with renal tumors. Mean patient age was 50 years (range 31 to 68). Mean tumor size was 4.1 cm (range 1.2 to 10.1). Mean RENAL nephrometry score was 6.1 (range 4 to 12). The renal hilar vessels were clamped in 14 surgeries, whereas 11 surgeries were carried out without clamping. The tumors were resected by cold scissors and monopolar hook. The tumor beds were coagulated by monopolar hookrepeatedly in spray and fulgurate modes.N-butyl-2-cyanoarcrylat (NBCA) was used in 13 patients when bleeding was observed after coagulation. Results: Mean operative time was 129.6 mins (range 70 to 300). Mean warm ischemic timein clamped cases was 22.6 min (range 15 to 32). Mean estimated blood loss was 166 ml (range 10 to 800). Mean hospital stay was 16.2 days (range 7 to 36). Two patients received blood transfusions. One patient received open surgery and suturing repair after failure of selective arterial embolization for postoperative hemorrhage. Two patients had urine leakage without any intervention. Conclusions: The technique using monopolar coagulation in sutureless LPN was safe and feasible. For exophytic and small tumors, the off-clamped technique could berecommended.