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Related Experiment Videos

Pathologic sampling of laparoscopically morcellated kidneys: a mathematical model.

Maxwell V Meng1, Theresa M Koppie, Marshall L Stoller

  • 1Department of Urology, University of California School of Medicine, San Francisco, California 94143-0738, USA. mmeng@urol.ucsf.edu

Journal of Endourology
|June 21, 2003
PubMed
Summary
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A new mathematical model guides the pathologic evaluation of morcellated kidney specimens, ensuring accurate diagnosis from numerous tissue fragments obtained during laparoscopic surgery.

Area of Science:

  • Urology
  • Pathology
  • Surgical Oncology

Background:

  • Kidney morcellation allows tissue removal via a port site during laparoscopic procedures.
  • Standard histopathologic examination methods for numerous morcellated kidney fragments are not established.
  • Laparoscopic removal of solid organs with suspected tumors is increasing.

Purpose of the Study:

  • To develop a model for guiding the pathologic evaluation of morcellated kidney tissue.
  • To establish a systematic approach for diagnosing fragmented specimens from laparoscopic surgery.

Main Methods:

  • A mathematical model was created using the hypergeometric distribution.
  • The model calculates the necessary quantity of morcellated tissue for diagnosis.
  • Inputs include estimated lesion size, total specimen volume, and desired diagnostic certainty.

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Main Results:

  • The model uses the formula P = 1 - (1 - k/N)(n) to determine diagnostic probability.
  • Nomograms were calculated to illustrate the model and provide clinical guidelines.
  • The model offers a feasible and practical approach to analyzing morcellated specimens.

Conclusions:

  • Morcellation of specimens precludes traditional pathologic examination.
  • A novel, systematic model assists in the histopathologic examination of morcellated specimens.
  • This sampling system provides a framework for histologic diagnosis in laparoscopic surgery.