Hand‐assisted retroperitoneoscopic radical nephrectomy

Dekuyper, P.; Oosterlinck, Willem

doi:10.1046/j.1464-410x.2003.04180.x

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…Hand‐assisted laparoscopic and retroperitoneoscopic nephrectomy have been reported to be procedures easily performed by surgeons without a great deal of experience 5–9 . Accordingly, these procedures may be suitable as a training method.…”

Section: Introductionmentioning

confidence: 99%

Learning curve of hand‐assisted retroperitoneoscopic nephrectomy in less‐experienced laparoscopic surgeons

et al. 2005

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Aim: To evaluate the learning curve of hand-assisted retroperitoneoscopic nephrectomy (HALS) performed by less-experienced surgeons. Methods: The operative records of 166 patients, including 103 with renal tumors and 63 with renal pelvic or ureteral tumors, who underwent HALS performed by 18 less-experienced urologists were reviewed. Results:The insufflation time in the first four cases was significantly longer than that in the sixteenth and later cases. The insufflation time in cases 5-10 was 14-24 min longer than that in the cases 16 onward, although the differences were not significant. The estimated blood loss did not differ in each group of cases. The complication rate in early cases, in which the operators' experience was five cases or less, was 6% (4/71), while that in later cases was also 7% (7/95). In the analysis of the learning curve of a single surgeon who performed 57 procedures, the insufflation time in cases 1-5 was significantly longer than in cases 41-57. The insufflation times in cases 5-10 were 45 min longer than those in cases 41-57, although the difference was not significant. The estimated blood loss did not differ in each group of cases. Complications did not seem related to operation experience. Conclusion:In HALS, 5-10 cases were necessary for less-experienced urologists to gain average operating skills for this procedure. It may be reasonable for less-experienced surgeons to begin standard laparoscopic procedures after experiencing 10 cases of the present procedure.

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Section: Introductionmentioning

confidence: 99%

Learning curve of hand‐assisted retroperitoneoscopic nephrectomy in less‐experienced laparoscopic surgeons

et al. 2005

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“…1 Despite these advantages, laparoscopic nephrectomy requires sophisticated techniques, morcellation of the specimen, and immediate open conversion in case of active bleeding. 8,9 However, despite the technical feasibility, current use of the retroperitoneal approach demands further study to recognize distinct advantages between the 2 different approaches. 3,4 Because of the ability to corporate the tactile sensation, 3-dimensional spatial orientation, and en bloc removal, hand-assisted laparoscopic radical nephrectomy is completed safely up to stage T2 RCC 5 and in cases with tumor thrombus in the renal vein.…”

mentioning

confidence: 99%

Hand-Assisted Laparoscopic Radical Nephrectomy

Shiraishi¹,

Eguchi²,

Mohri³

et al. 2005

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

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Transperitoneal and retroperitoneal approaches have been introduced to perform hand-assisted laparoscopic radical nephrectomy. The efficacy and convalescence of both approaches were compared. Of 26 patients with renal cell carcinoma, 14 patients were treated by the transperitoneal approach and 12 by the retroperitoneal approach at the same institution. The mean operative time by transperitoneal approach was significantly shorter than retroperitoneal approach (236.4 and 280.0 minutes, respectively, P < 0.05), but there is a steeper learning in retroperitoneal approach. A significant increase in operative time was required with an increase in specimen weight (r = 0.591, P < 0.05). There were no differences in patient demographic, operative, and convalescence data between the both groups. Hand-assisted laparoscopic radical nephrectomy is safe by either the transperitoneal or the retroperitoneal approach. Making enough retroperitoneal space for the hand and instrument enables us to use the retroperitoneal approach readily. Patients with abundant fatty tissues around the kidney should be treated by the transperitoneal approach.

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“…I read this report [1] with interest; the authors claim to be able to do retroperitoneoscopic hand‐assisted radical nephrectomy in a manner that is feasible, fast and offers significant advantages to the patient and the surgeon. The retroperitoneum is a potential space; retroperitoneoscopy is only possible after artificially creating a pneumoretroperitoneum.…”

mentioning

confidence: 99%