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Related Experiment Videos

Hand-assisted laparoscopy for large renal specimens: a multi-institutional study.

Michael D Stifelman1, Toby Handler, Alan M Nieder

  • 1Department of Urology, New York University Medical Center, New York, New York 10016, USA.

Urology
|February 1, 2003
PubMed
Summary

Hand-assisted laparoscopy (HAL) is effective for removing large kidney tumors and tumors in obese patients. While recovery may be longer for these cases, HAL offers a safe, minimally invasive approach with no increased risk of recurrence.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Hand-assisted laparoscopy (HAL) offers theoretical advantages for managing large renal specimens.
  • Defining large renal tumors as greater than 7 cm and considering obese patients is crucial for surgical planning.

Purpose of the Study:

  • To evaluate the safety and efficacy of HAL for large renal tumors (≥7 cm) and tumors in obese patients.
  • To compare outcomes of HAL for large/obese patients versus standard cases.

Main Methods:

  • Retrospective review of 106 HAL radical nephrectomies (1998-2000).
  • Comparison of 32 patients with large tumors (≥7 cm) and 41 obese patients (BMI ≥31) against control groups.
  • Analysis of demographic and outcome data, including operative time, blood loss, and recurrence rates.

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Main Results:

  • Patients with large tumors (≥7 cm) had longer convalescence (21 vs. 18 days).
  • Obese patients experienced longer operative times (214 vs. 176 min) and convalescence (21 vs. 17.5 days).
  • No significant differences in blood loss, conversion rates, positive margins, or recurrence were observed between groups.

Conclusions:

  • HAL is a safe, reproducible, and minimally invasive technique for large renal tumors and tumors in obese individuals.
  • The oncologic outcomes for HAL in these specific patient groups are comparable to standard cases.