Hand-Assisted Retroperitoneoscopic Nephroureterectomy for Upper Urinary-Tract Urothelial Tumors

Uozumi, Jiro; Fujiyama, Chisato; Meiri, Hiroyuki; Tsukahara, Tsunehiro; Soejima, Kyoko; Kanou, Takehiro; Masaki, Zenjiro

doi:10.1089/08927790260472890

Cited by 24 publications

(13 citation statements)

References 18 publications

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“…[4][5][6][7][8][9][10] In addition, potential disadvantages of open nephroureterectomy include contralateral ureteral orifice compromise, inadequate excision of the entire ureter and bladder cuff, and technical difficulty in obese patients. 11,12 Laparoscopic nephroureterectomy has been described with considerable variation in the excision of the distal ureter and bladder cuff. The five main techniques that have the pluck technique, and ureteral intussusceptions.…”

Section: Discussionmentioning

confidence: 99%

Initial Experience with Robot-Assisted Minimally-Invasive Nephroureterectomy

Silletti

Williams

2008

Journal of Endourology

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Section: Discussionmentioning

confidence: 99%

Initial Experience with Robot-Assisted Minimally-Invasive Nephroureterectomy

Silletti

Williams

2008

Journal of Endourology

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“…According to a review of the literature, there are three types of hand port incisions for HARNU and open lower ureter and bladder cuff resection; these include the lower midline, the paramedian, and the Gibson incision [11,12,17]. Considering cosmetic outcomes, we tried to make a lower Gibson incision to ensure that the 7.0-cm scar could be hidden by undergarments.…”

Section: Discussionmentioning

confidence: 99%

Hand-Assisted Retroperitoneoscopic Nephroureterectomy With Bladder Cuffing After Preperitoneal and Retroperitoneal Perivesical Ballooning

Kim

et al. 2014

Korean J Urol

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PurposeWe aimed to describe the surgical technique of hand-assisted retroperitoneoscopic nephroureterectomy (HARNU) with bladder cuffing after preperitoneal and retroperitoneal perivesical ballooning.Materials and MethodsFrom March 2008 to September 2012, we performed HARNU and open bladder cuffing in 28 consecutive series of patients with upper urinary tract urothelial carcinoma. We performed HARNU according to the following procedure: (1) a camera port incision was made on the posterior axillary line; (2) multiple, repeated, preperitoneal and retroperitoneal ballooning was performed on both the posterior axillary line and in the umbilicus; (3) a 7.0 cm skin incision was made from the suprapubic to the lower inguinal with the balloon present in the extraperitoneal area; (4) hand-assisted laparoscopic retroperitoneal nephroureterectomy; (5) cessation of gas insufflation; and (6) extravesical cuffing as an open surgical procedure.ResultsThe mean estimated blood loss was 250 mL. The mean operation time was 240 minutes. The mean time to oral intake and ambulation was 1.0 day and two days, respectively. As for postoperative complications due to the hand-assisted device, one patient developed febrile urinary tract infection within three weeks postoperatively and was hospitalized again to receive parenteral antibiotics.ConclusionsWe made a low Gibson incision for a route for the hand-assisted procedure as well as a window for open surgery in dissecting the distal ureter and extracting the surgical specimens. Thus, our results indicate that the HARNU might be a feasible surgical modality.

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“…5,11,12 The open nephroureterectomy technique also has some potential disadvantages, such as contralateral ureteral orifice compromise, inadequate excision of the bladder cuff, and technical difficulty especially in obese patients. 13,14 We believe that the robot-assisted laparoscopic approach with good surgical vision, prevention of tremors, and accurate mobility is also a good alternative to open and to laparoscopic nephroureterectomy excision of the distal ureter and bladder cuff. Rose and colleagues 15 initially described the use of robot-assisted laparoscopic nephroureterectomy.…”

Section: Discussionmentioning

confidence: 99%