Related Experiment Videos
Retroperitoneoscopic partial nephrectomy using microwave coagulation for small renal tumors
Takashi Murota1, Mutsushi Kawakita, Naoki Oguchi
1Department of Urology, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka 570-8507, Japan.
Objectives:
The outcome of laparoscopic partial nephrectomy using a microwave tissue coagulator for treatment of small renal tumors was studied.
Patients And Methods:
From June 1999 to May 2001, eight patients with small renal tumors of less than 5.0cm in diameter (1.0-5.0cm, T1N0M0) underwent retroperitoneoscopic partial nephrectomy. To control bleeding during the partial nephrectomy, the renal parenchyma around the tumor was coagulated using a microwave tissue coagulator with a needle of 1.5cm length. The tumor was circumscribed within the coagulated area with 8-13 punctures of the coagulation needle, and partial nephrectomy was performed using scissors and bipolar forceps.
Results:
All eight patients successfully underwent the procedure retroperitoneoscopically. The average operative time was 295 minutes and the average blood loss was 129ml. Three patients showed urine leakage from the renal calyces, which was controlled by suturing retroperitoneoscopically. In two patients, the surgical margin was revealed to be positive for renal cell carcinoma by frozen section pathology and additional resection was performed in these individuals. The patients were discharged from the hospital with almost full convalescence on day 10 on average. Within the mean follow-up period of 10.4 months, no recurrence was found when examined with computer tomography (CT) using contrast media. As a complication, one patient experienced a decrease in function of the operated kidney caused by unknown reason.
Conclusion:
Retroperitoneal partial nephrectomy using a microwave tissue coagulator is useful for treatment of small renal tumors located at the peripheral area of the kidney. Bleeding from the renal parenchymal incision site is well controlled without occlusion of the renal artery with additional use of a bipolar coagulator, when necessary. Further experience and long-term follow-up are mandatory however, to establish the usefulness of this technique.
Insights
Retroperitoneal partial nephrectomy with a microwave tissue coagulator effectively treats small renal tumors. This minimally invasive technique controls bleeding and offers good outcomes for peripheral kidney lesions.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Oncology
Background:
- Small renal tumors are increasingly detected.
- Partial nephrectomy is the standard treatment for localized renal tumors.
- Minimally invasive techniques are preferred for renal tumor resection.
Purpose of the Study:
- To evaluate the efficacy and safety of retroperitoneoscopic partial nephrectomy using a microwave tissue coagulator for small renal tumors.
- To assess the feasibility of controlling bleeding during the procedure without renal artery occlusion.
Main Methods:
- Eight patients with T1N0M0 renal tumors (<5cm) underwent retroperitoneoscopic partial nephrectomy.
- A microwave tissue coagulator was used to coagulate parenchyma around the tumor.
- Tumor resection was performed using scissors and bipolar forceps.
Main Results:
- All eight patients completed the procedure successfully with an average operative time of 295 minutes and blood loss of 129ml.
- Three patients experienced urine leakage, managed by suturing. Two patients required additional resection due to positive surgical margins.
- No recurrence was observed during a mean follow-up of 10.4 months, though one patient had decreased kidney function.
Conclusions:
- Retroperitoneal partial nephrectomy with a microwave tissue coagulator is a viable option for peripheral small renal tumors.
- The technique effectively controls parenchymal bleeding without renal artery clamping.
- Further studies and long-term follow-up are needed to confirm the technique's long-term benefits.