Differences in Complications and Outcomes for Obese Patients Undergoing Laparoscopic Radical, Partial or Simple Nephrectomy

Is simple nephrectomy truly simple? Comparison with the radical alternative

“…Deliberately all laparoscopic cases have been excluded, for obvious reason, from analysis in this study, but it may be reasonable to extrapolate our findings to the laparoscopic setting. Interestingly, however, a recent report based on laparoscopic transperitoneal surgery by Anast et al [8] reported 30 simple nephrectomies to be associated with longer mean operative times than the radical laparoscopic counterpart, possibly arising due to increased technical difficulty caused by inflammation or prior surgeries. Further comparison between specific laparoscopic groups will be required in the future.…”

Hand-Assisted Laparoscopic Nephroureterectomy (HALNU): An Assessment of the Impact of Obesity in 50 Procedures

“…[3][4][5] Hand-assisted laparoscopic nephrectomy has been reported as safe and effective in the morbidly obese. 6 However, while laparoscopic and hand-assisted laparoscopic nephroureterectomy (HALNU) have been reported to provide equal efficacy and be better tolerated than their open surgery counterpart [7][8][9][10] and HALNU observed to significantly reduce operative time compared with standard laparoscopic NU, 11 there is a paucity of literature addressing the impact of obesity on performing either standard laparoscopic or HALNU.…”

Retroperitoneoscopic Radical Nephrectomy in Obese Patients: Outcomes and Considerations

“…The fl ank has less subcutaneous fat, allowing use of normal-sized laparoscopic ports and instruments in obese patients [11] . Clinically we have observed that obese patients store most of their excess fat in subcutaneous tissue and do not have signifi cantly more retroperitoneal or intra-abdominal fat than non-obese patients [7] . Although minor technical modifi cations were necessary, the benefi ts of the minimally invasive RRN technique were preserved in the obese patients.…”

“…Indeed, more than 20% of Japanese adults are considered overweight (BMI 6 25.0 kg/m 2 ), and more than 3% are obese (BMI 6 30.0 kg/m 2 ) [7] . Despite the differences in perioperative outcome for obese and non-obese patients in our study, obese patients did not have more complications, conversions to open surgery, longer hospital stays or longer time to oral intake and start of ambulation.…”