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Hand-assisted laparoscopic nephroureterectomy: description of technique
D E McGinnis1, E J Trabulsi, L G Gomella
1Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA.
Techniques in Urology
|March 29, 2001
Summary
Hand-assisted laparoscopic nephroureterectomy (HALNU) offers an effective minimally invasive option for upper urinary tract transitional cell carcinoma (UTTCC). This technique provides a viable alternative to traditional open surgery with favorable outcomes.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Upper urinary tract transitional cell carcinoma (UTTCC) traditionally requires open nephroureterectomy.
- Open surgical techniques often involve multiple incisions and prolonged recovery.
Purpose of the Study:
- To review the experience and technique of hand-assisted laparoscopic nephroureterectomy (HALNU).
- To evaluate HALNU as a minimally invasive treatment for UTTCC.
Main Methods:
- HALNU was performed on 32 patients by three surgeons between August 1998 and October 2000.
- The distal ureter and bladder cuff were managed laparoscopically, with two different techniques employed for closure or combined cystoscopic/laparoscopic resection.
Main Results:
- The primary indication was UTTCC in 29 patients.
- Mean operative time was 372 minutes, mean blood loss was 541 cc, and mean hospital stay was 5.5 days.
- No positive surgical margins, local recurrences, or wound/trocar site seeding were observed.
Conclusions:
- Hand-assisted laparoscopic nephroureterectomy (HALNU) is an effective treatment for UTTCC.
- HALNU represents a successful minimally invasive surgical approach for managing UTTCC.