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Hand-assisted laparoscopic partial nephrectomy.
M D Stifelman1, R E Sosa, S Y Nakada
1Department of Urology, New York University Medical Center, New York 10021, USA. uro99@hotmail.com
Journal of Endourology
|April 28, 2001
Summary
Hand-assisted laparoscopy (HAL) offers a feasible approach for partial nephrectomy, enabling less invasive procedures for renal lesions and duplicated systems. This technique facilitates dissection and hemostasis, with promising short-term outcomes and minimal complications.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Indications for partial nephrectomy are expanding.
- Traditional partial nephrectomy requires a large flank incision.
- Hand-assisted laparoscopy (HAL) presents a less invasive alternative.
Purpose of the Study:
- To report the experience with HAL for partial nephrectomies.
- To evaluate the feasibility and outcomes of HAL partial nephrectomy.
Main Methods:
- 11 HAL partial nephrectomies performed between October 1999 and May 2000.
- Utilized Harmonic Scalpel and argon beam coagulator for excision.
- Applied various hemostatic agents and reinforced sutures for defect closure.
Main Results:
- Average operative time: 273 minutes; estimated blood loss: 319 mL.
- No transfusions required; one conversion to open surgery.
- Average hospital stay: 3.3 days; no major complications.
Conclusions:
- HAL partial nephrectomy is feasible and reproducible.
- Surgeon's hand in the operative field aids dissection, vascular control, and hemostasis.
- Further long-term and prospective studies are warranted.