Titanium clips for vascular control of renal vessels during laparoscopic nephrectomy: a safe and cost effective tertiary care center experience

Abstract

This study aimed to evaluate the safety and cost-effectiveness of practice of titanium clip application on renal vessels in laparoscopic nephrectomy (LN) in a tertiary care hospital. A total of 143 patients were included in our study undergoing laparoscopic nephrectomy from January 2018 to April 2023. In our study, 3 titanium clips were applied on each renal artery and vein 1-2 mm apart from each other in order to achieve vascular control of the renal pedicle. This data was obtained retrospectively through medical records. We reported 31 (22%) patients in our study with malignant conditions and 112 (88%) patients with benign diseases. Of these, 4 (3 %) patients required blood transfusion. There were four cases where laparoscopic nephrectomy was converted to open procedure. No incidence of slippage of titanium clips used for vascular ligation was reported in our study neither did we encounter any clip dislodgement during or after the surgery. No significant post-operative complications pertaining to clip application were seen. Cost analysis revealed that most cases required a total of 6 titanium clips costing around 8 USD (4 USD per cartridge of 6 titanium clips) in total for vascular control. Titanium clip application for securing renal vessels during laparoscopic nephrectomy is a safe and cost-effective approach.