Abstract
The purpose of the present paper is to describe our technique and experience with retroperitoneal hand-assisted laparoscopic (HAL) nephrectomies as an alternative to the transperitoneal approach. Eight retroperitoneal HAL nephrectomies and one partial nephrectomy were performed. Several excisional techniques were employed incorporating the Harmonic scalpel or Ligasure device. Hemostatic agents were used to cover the renal defect. Surgical bolsters were sutured to the renal capsule with pleget reinforcements to aid in hemostasis. The average operative time was 210 min and estimated blood loss 110 mL. Mean change in hematocrit was 3 units and creatinine was 1 point. No patient required a transfusion. There were no major complications, with a mean follow-up of fourteen months. On average, patients resumed oral intake in 2 days, and were discharged in 3 days. Pathological examination revealed that two lesions were benign and seven malignant. Tumor diameter averaged 3 cm. There were no positive surgical margins. In conclusion, we have demonstrated the feasibility of retroperitoneal laparoscopic hand-assisted nephrectomy and partial nephrectomy surgery for solid renal masses.
Highlights
Introduction outcomes of retroperitoneal hand-assisted laparoscopic (HAL) nephrectomyThe first step in extra-peritoneal HAL renal in compara- surgery is to gain access to the retroperitoneal tive experience with standard transperitoneal space, and position a hand through an incisionThe initial technique for open and partial techniques.in the anterior abdominal wall
HAL combines the advantages of laparoscopy with quicker and safer organ retrieval offered by open surgery
This retroperitoneal technique is advantageous in patients who have undergone previous abdominal surgery, and may have excessive peritoneal adhesions. This approach is beneficial in patients whom are on peritoneal dialysis (PD), because the peritoneal cavity is not violated and PD does not have to be stopped postoperatively. To avoid such potential intraperitoneal complications, we present a technique for retroperitoneal handassisted laparoscopic nephrectomy and partial nephrectomy
Summary
Introduction outcomes of retroperitoneal HAL nephrectomyThe first step in extra-peritoneal HAL renal (performed for solid renal mass) in compara- surgery is to gain access to the retroperitoneal tive experience with standard transperitoneal space, and position a hand through an incisionThe initial technique for open and partial techniques.in the anterior abdominal wall. We c have demonstrated the feasibility of retroperi- toneal laparoscopic hand-assisted nephrecton my and partial nephrectomy surgery for solid No renal masses.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
