Open conversion from laparoscopic nephrectomy: slippage of surgical clips ligating the renal artery affected by atherosclerosis.

Major vessel ligation is the most critical part of laparoscopic surgery, and clips and staplers are mainly used for this purpose. We report an open conversion from laparoscopic nephrectomy in which 4 consecutive clips placed at the renal artery slipped out in a patient with a history of atherosclerosis. Pathological examination of the renal artery revealed a thickened intima of the vessel wall. We suggest that a stapler probably provides more secure ligation for hardened and thickened arteries when performing laparoscopic nephrectomy. CASE REPORT