LAPAROSCOPIC UROLOGY: Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy for Predominantly Endophytic Renal Tumors

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Engel Jason D.; Williams Stephen B.

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Journal Paper

Paper Information

Journal: UROLOGY JOURNAL Year:2013 | Volume:10 | Issue:1 Page(s): 767-773

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Title

LAPAROSCOPIC UROLOGY: Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy for Predominantly Endophytic Renal Tumors

Author(s)

Engel Jason D. | Williams Stephen B. | Issue Writer Certificate

Keywords

kidney neoplasms

hand-assisted laparoscopy

nephrectomy

ischemia

Abstract

PURPOSE: To describe our initial experience with unclamped laparoscopic hand-assisted partial nephrectomy for predominantly endophytic renal masses in the setting of relative contraindication to warm ischemia. MATERIALS AND METHODS: Unclamped laparoscopic hand-assisted partial nephrectomy was performed on eight consecutive patients from June 2009 to March 2010. All patients had predominantly endophytic renal masses with a preferential enhancing rim noted on the pre-operative computed tomography. The unclamped hand-assisted approach was utilized for no warm ischemia, minimal blood loss, and enhanced visualization of the tumor bed with improved operative exposure. RESULTS: Mean age of the participants was 55. 8 years. All patients underwent unclamped hand-assisted partial nephrectomy (ie, zero ischemia). Mean estimated blood loss was 368. 8 cc (range, 100 to 800 cc) and mean operation time was 236. 9 minutes (range, 175 to 272 minutes). There were no intra-operative complications and no open conversions. There was one grade II (ileus with small pneumothorax) and one grade IV (pulmonary embolism) in the 90-day peri-operative period. There was one positive surgical margin, which was recognized intra-operatively. CONCLUSION: While our results are preliminary, we feel this technique provides superior visualization and adequate hemostasis while preserving oncologic efficacy and renal function in this patient population.

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APA: Copy

Engel, Jason D., & Williams, Stephen B.. (2013). LAPAROSCOPIC UROLOGY: Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy for Predominantly Endophytic Renal Tumors. UROLOGY JOURNAL, 10(1), 767-773. SID. https://sid.ir/paper/271082/en

Vancouver: Copy

Engel Jason D., Williams Stephen B.. LAPAROSCOPIC UROLOGY: Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy for Predominantly Endophytic Renal Tumors. UROLOGY JOURNAL[Internet]. 2013;10(1):767-773. Available from: https://sid.ir/paper/271082/en

IEEE: Copy

Jason D. Engel, and Stephen B. Williams, “LAPAROSCOPIC UROLOGY: Unclamped Hand-Assisted Laparoscopic Partial Nephrectomy for Predominantly Endophytic Renal Tumors,” UROLOGY JOURNAL, vol. 10, no. 1, pp. 767–773, 2013, [Online]. Available: https://sid.ir/paper/271082/en

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