Strategies to Extend Warm Ischemia Time during Laparoscopic Partial Nephrectomy- Part II

Background and aims: in this part of the review, particular attention is drawn towards the mecha nisms by which one can pre-condition the kidneys pre-operatively by using several strategies that are nutritional, biochemical, pharmacological and environmental in nature. in addition, ideas and hypotheses are put forward that are relevant to modulating the anoxic and autophagic response to ischemic damage during laparoscopic partial nephrectomy, particularly with respect to reducing the endoplasmic reticulum stress. finally, the current trends in research involving the role of stem cells, renal hibernation and the role of the innate immune response are highlighted with the aim of exploiting these mechanisms to achieve reduced kidney damage during ischemia. finally, the common thread behind all these approaches, namely empowering the renal mitochondria during ischemia is emphasized.