Laparoscopic Retroperitoneal Extirpative and Reconstructive Renal Surgery<sup />

Hemal, Ashok K.

doi:10.1089/end.2010.0697

Cited by 8 publications

(5 citation statements)

References 31 publications

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“…A total of eight patients were undergo to laparoscopic anatrophic nephrolithotomy, mean patients age were 42.1 years, stone diameter was 52.6mm, 5 stones (62.5%) were found in left topography and 3 stones (37.5%) were in the right topography, mean surgical time 127.5 minutes [7,8], warm ischemia time 29.5 minutes, blood loss average 218.7ml, transfusion rate 0%, 2 complications (25%), we decided to perform a nephrectomy in a patient due to prolonged ischemia and one patient was discharge with no complications but he returns to the emergency room with gross hematuria [9] days postoperatively, which did not yield to medical treatment also the non-availability to performed an angiography + embolization (high suspicion of pseudoaneurisma). Stone free rate was 75%, length in hospital were 3.5 days.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Anatrophic Nephrolithotomy a Feasible Option in Staghorn Calculi

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2017

JOJUN

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Introduction: Management of stag horn calculi still being real challenge for urologists dedicated to stone management. Nowadays it is difficult to obtain a free stone rate with a single procedure in these complex cases even with the recent advances in endourology. The aim of this study is to present our results and review of published case series in PubMed. Patients and method:We reported our experience in laparoscopic anatrophic nephrolithotomy in 8 patients with stag horn calculi diagnosis between 2014-2015. We evaluated patient variables like age, stone size, surgical time, blood loss, transfusion, complications, hospitalization days and free stone rate. And we performed a comparison with previous case series published. It is worth highlighting that the same surgeon performed all surgeries.Results: A total of 8 patients undergo to laparoscopic anatrophic nephrolithotomy, patients mean age was 42.1 years, stone size 52.63mm, surgical time 127.5 min, warm ischemia 29.5 minutes, blood loss 218.7 ml, transfusion rates 0%, complications 25%, hospitalization days 3.5 days and stone free rate was 75%. Conclusion:Laparoscopic anatrophic nephrolithotomy could be a feasible option in high volume centers to patients with complex renal stones that will require multiple percutaneous and endourologic procedures, or those who are no candidates to percutaneous nephrolithotomy. Achieving laparoscopic anamorphic nephrolithotomy a reasonably stone free rate with one procedure.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic Anatrophic Nephrolithotomy a Feasible Option in Staghorn Calculi

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2017

JOJUN

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“…Relevant anatomical research [5] shows renal sinus fat,enclosing the renal vessels, between the pelvis and parenchyma has a close relationship to renal parenchyma. A layer of connective tissue (the renal pelvis membrane) exists between the sinus fat and pelvis, whose blood supply is from the pelvic muscle layer but not from renal vessels in sinus fat.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases

Qin

Wang

et al. 2014

BMC Urol

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BackgroundIn most hospitals, several options for the management of renal stones are available: shockwave lithotripsy, endourologic treatment, or surgery. Choice of treatment is based on the anatomic characteristics of the patient, and the location and size of the stones. In this study we assessed a retroperitoneal laparoscopic technique for treatment of complex renal stones.MethodsSeventy-five patients, including 53 men and 22 women with a mean age of 47.8 years (range 18–74 y), underwent retroperitoneal laparoscopy for the treatment of complex renal stones between July 2006 and November 2012 in our hospital.ResultsThe retroperitoneal laparoscopic procedures for treatment of complex renal stones were completely successful in 73 cases, while 2 cases converted to open surgery. The operative time was 85–190 min with a mean of 96 min. The estimated blood lost was 20–400 mL with a mean of 80 mL. After the operation 7 patients experienced urinary leakage. Ultrasonography, x-ray of the kidney, ureter and bladder, and intravenous urography were reviewed at post-procedural follow-up at 6–82 months. No hydronephrosis aggravation was found, and there was no calculus recurrence.ConclusionThe merits of retroperitoneal laparoscopy for the treatment of complex renal stones include sparing the nephron, less bleeding, short hospitalization, quick postoperative recovery, and controllable procedure after training Success depends on the experience of surgeons and judicious selection of cases.

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“…However, despite the several advantages of the retroperitoneal approach, RLESS has been less commonly reported because it is more difficult to check anatomical landmarks with RLESS and there is more clashing of laparoscopic instruments due to the relatively small working space compared with the transperitoneal approach [11]. Recently, a large multi-institutional, worldwide series of LESS in urology was reported, in which a total of 1,076 cases of LESS done at 18 institutions were included.…”

Section: Discussionmentioning

confidence: 99%

“…The retroperitoneal approach has some advantages compared with the transperitoneal approach, which allows more direct access to the kidney and renal hilum and has the merits of rare retraction of internal organs and less risk of peritoneal contamination by spillage of urinary contents such as urine, tumor, or abscess [11]. …”

Section: Introductionmentioning

confidence: 99%

Initial Experience with Retroperitoneal Laparoendoscopic Single-Site Surgery for Upper Urinary Tract Surgery

2011

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PurposeTo report our initial clinical experience and perioperative outcomes of retroperitoneal laparoendoscopic single-site surgery (RLESS) for upper urinary tract surgery.Materials and MethodsBetween June 2009 and October 2010, we performed RLESS in 23 patients for various indications including radical nephrectomy (n=4), nephroureterectomy (n=2), simple nephrectomy (n=10), and renal cyst ablation (n=7). RLESS was performed with a homemade single-port device with a conventional rigid laparoscopic instrument and laparoscope. The parameters analyzed were age, body mass index, operative time, estimated blood loss, transfusion, time of oral intake, visual analogue pain scale score (VAPS), length of hospital stay, and complications.ResultsOne case of simple nephrectomy was converted to open nephrectomy because of severe adhesion and inadequate surgical exposure. RLESS was completed in 23 patients. Mean operative time was 168.7±29.2, 227.5±50.0, 230.0±56.5, and 70.5±8.9 minutes for simple nephrectomy, radical nephrectomy, nephroureterectomy, and renal cyst ablation, respectively. Estimated blood loss was 113.0±149.8, 170.0±156.8, 400.0±141.4, and 22.8±16.0 ml. The time to oral intake after surgery was 1.4±0.5, 1.2±0.5, 1.5±0.7, and 1.1±0.3 days. The mean VAPS score was 1.1±0.2, 2.1±0.5, 2.0±0.5, and 1.0±0.0 of 10 (range, 0.8 to 2.6). The hospital stay was 4.6±1.5, 3.7±0.5, 6.0±1.4, and 3.2±1.7 days. No major perioperative complications were observed.ConclusionsThe initial outcomes of our experience suggest that RLESS is a technically feasible and safe procedure for upper urinary tract surgery. Prospective comparative studies with conventional retroperitoneal laparoscopic surgery are needed to confirm the potential benefits of RLESS.

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Laparoscopic Retroperitoneal Extirpative and Reconstructive Renal Surgery

Cited by 8 publications

References 31 publications

Laparoscopic Anatrophic Nephrolithotomy a Feasible Option in Staghorn Calculi

Laparoscopic Anatrophic Nephrolithotomy a Feasible Option in Staghorn Calculi

Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases

Initial Experience with Retroperitoneal Laparoendoscopic Single-Site Surgery for Upper Urinary Tract Surgery

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