Ces Urol 2003, 7(2):22-25 | DOI: 10.48095/cccu2003015

Hand-assisted laparoscopic nephrectomy for renal tumor: technique without creating pneumoperitoneum

I. Lutter¹, I. Daniel², R. Wagenhoffer¹, J. Pechan², P. Weibl¹

¹ Urologické oddelenie

² II. Chirurgická klinika LF UK NsP Sv. Cyrila a Metoda, Bratislava, SR

Introduction and aim: The authors demonstrate their experience with the hand assisted tumornephrectomy (HALN) without using the pneumoperitoneum. For creating an sufficient working space inside the abdomen they used a special abdominal wall sealing device.

Materials and methods: Between March 2002 and July 2002 they performed 5 hand assisted laparoscopic procedures without using the pneumoperitoneum. The average patient age was 52. The tumor size ranged from 6 up to 10 cm.They performed 4 right sided and one left sided tumornephrectomy. Clinical staging was T1 and T2 without the enlargement of the lymph nodes and distant metastasis.

Results: They successfully completed the extraction of the tumor in all the cases. The operation time was 90-220 min., the average blood loss was 120ml. No serious perioperative and postoperative complications appeared. No conversion was necessary. Redon drain was left in bedside for one day. Hospital stay was from 4 to 6 days. The mean time of the convalescence was 4 weeks.

Conclusion: HALN without using the pneumoperitoneum is a new, safe, reproducible and minimally invasive technique for the extraction of the larger tumors while fulfilling the oncological principles of the classic surgery.

Keywords: nephrectomy, hand-assisted, gas less, laparoscopy, renal cell carcinoma

Published: March 1, 2003