Application of hidden incision in specimen extraction of robot-assisted laparoscopic pediatric radical nephrectomy

Abstract

To investigate the value of hidden incision applied to specimen extraction in children's robot-assisted laparoscopic radical nephrectomy. The clinical data of robotic-assisted laparoscopic radical nephrectomy in our hospital were retrospectively analyzed. The patients were treated with 60° lateral position and the eyepiece Trocar was located at the umbilical contralateral margin. The operation hole 1 is located 6-7 cm above the anterior median line (depending on the abdominal wall space of the child), and the operation hole 2 is located at the intersection of the anterior median line and the lower transverse Pfannenstiel, Trocar sneaked under the skin, and then inserted into the abdominal cavity (1.5cm above the operation hole 2) , if the auxiliary hole is needed, the auxiliary hole Trocar is placed on the affected side of the lower abdominal transverse line. All the operations are performed with radical resection. The specimen was placed in the specimen bag, then extend the lower abdominal transverse incision (the length of the incision is the smallest diameter of the kidney), the specimen bag is taken through the incision (Pfannenstiel incision), and the wound is partially injected with ropivacaine mesylate. Postoperative routine cefuroxime to prevent infection, no analgesic pump. A total of 7 patients with robot-assisted laparoscopic radical nephrectomy were enrolled in our hospital from August 2015 to February 2019, including 4 boys, 3 girls, 5 left side, 2 right side. The average length of the incision is 6.5cm (5.5-7.0cm). All the specimens were completely removed. The average postoperative hospital stay was 4.5 days (4-7 days). There was no active bleeding, splitting, infection in the postoperative wound, the average follow-up time is 25m (4-46m), no scar hyperplasia was observed. The hidden incision (Pfannenstiel incision) can be safely and effectively applied to specimen extraction in children's robot-assisted laparoscopic radical nephrectomy.