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Laparoscopic partial nephrectomy: integration of an advanced laparoscopic technique.
Prem Rashid1, Jeremy Goad, Monish Aron
1Department of Urology, Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia. prem@urologycentre.com
ANZ Journal of Surgery
|June 5, 2008
Summary
Laparoscopic partial nephrectomy is a secure treatment for complex kidney tumors, but requires advanced skills. Disseminating these skills is crucial for wider adoption in Australian and New Zealand urology practices.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Oncology
Background:
- Laparoscopic radical nephrectomy and open partial nephrectomy are established treatments for renal malignancy.
- Laparoscopic partial nephrectomy (LPN) has evolved significantly.
- The study evaluates the current status of LPN and skill acquisition in Australia and New Zealand.
Purpose of the Study:
- To evaluate the current status of laparoscopic partial nephrectomy.
- To assess skill acquisition for advanced laparoscopic urology in the Australian and New Zealand context.
Main Methods:
- Literature search of PubMed for laparoscopic partial nephrectomy, renal failure, nephrectomy, and surgical training.
- Selection based on contribution to technique development, clinical outcomes, and comparisons with current management.
Main Results:
- LPN technique and outcomes are secure for complex tumors in experienced hands.
- Consideration of radical nephrectomy's impact on renal function is vital for small renal masses.
- Robotic-assisted surgery is costly and may hinder advanced laparoscopic skill acquisition.
Conclusions:
- Laparoscopic partial nephrectomy is a standard of care at tertiary institutions with sufficient laparoscopic skill.
- Widespread dissemination of advanced laparoscopic skills is the next challenge for LPN adoption.
