ABSTRACT
Laparoscopic nephrectomy has evolved since the first reported case by Clayman et al. (1) and is an acceptable alternative for live renal donation (2,3) and the treatment of benign (4,5) and malignant disease (6,7). Early challenges the procedure involved the controlled ligation and division of the renal artery and renal vein. The GIA was developed and allowed for safe controlled ligation and division of the intended vessel. Failure of the device, however, can be associated with severe consequences including emergent conversion to an open procedure and the possible loss of renal allograft in cases of live kidney
donation. The majority of problems, however, can be avoided with careful application and recognition. Many failures, especially if recognized prior to release of the device, can be managed without conversion to an open procedure.
