SHEFLER ET AL. © 2011 THE AUTHORS 1688 BJU INTERNATIONAL © 2 0 11 B J U I N T E R N A T I O N A L | 1 0 7 , 1 6 8 8 - 1 6 9 3 | doi:10.1111/j.1464-410X.2011.10314.x Surgery Illustrated – Focus on Details Renal hilus clamping with tourniquet during laparoscopic partial nephrectomy Alex Shefler, Ahmed Ghazi, Rheinhold Zimmermann and Günter Janetschek* Department of Urology, Krankenhaus der Elisabethinen, Linz, and *Department of Urology and Andrology, University Hospital Salzburg, Austria ILLUSTRATIONS by STEPHAN SPITZER, www.spitzer-illustration.com INTRODUCTION Laparoscopic partial nephrectomy (LPN) is a continuously developing technique. On-going developments allow the experienced laparoscopist to use laparoscopic surgery for virtually all patients who are eligible for elective PN [1]. The procedure still includes a potential risk of significant complications and therefore requires considerable expertise in the laparoscopic ETAL. BJUI BJU INTERNATIONAL in LPN. For the laparoscopic setting most authors described clamping with laparoscopic Satinsky or bulldog clamps [4,9,10]. In this article we describe the technique of achieving renal vascular occlusion using vessel loop tourniquet for LPN. We will focus on the detailed operative technique, our suggested technical modifications and then discuss its advantages over the laparoscopic Satinsky or bulldog clamps. field to be successful [2]. Despite evolving techniques and technologies aimed to facilitate LPN [3], duplication of open surgical principles including transient renal vascular clamping, can be viewed as standard in most cases [3–8]. In an attempt to improve outcomes and minimize complications, different approaches and devices have been described for renal vascular clamping