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Hand-assisted laparoscopic nephrectomy: complications related to the hand-port site
A A Okeke1, A G Timoney, F X Keeley
1Bristol Urological Institute, Southmead Hospital, Bristol, UK. frank_keeley@bui.ac.uk
Objective:
To evaluate the early results of hand-assisted radical nephrectomy and nephroureterectomy in our institution.
Patients And Methods:
The records of 13 patients with malignant disease of the kidney who underwent hand-assisted laparoscopic radical nephrectomy and nephroureterectomy were reviewed retrospectively. Clinical outcomes were compared with a series of 16 patients who underwent similar procedures via a standard laparoscopic approach.
Results:
There were three major hand-port wound complications in those who underwent hand-assisted procedures, while one other patient required conversion because of technical failure of the device. The operative duration, length of hospital stay, estimated blood loss, transfusion rate, analgesic requirement, conversion rates, and minor complications were similar between the hand-assisted and standard laparoscopy groups.
Conclusion:
There was little difference between hand-assisted and standard laparoscopy in operative duration or recovery, but there were problems with wound complications which may be related to the hand-assisted approach. We have consequently abandoned the technique in favour of a standard laparoscopic approach.