Gasless hand-assisted retroperitoneoscopic nephroureterectomy

To assess the efficacy of gasless hand-assisted retroperitoneoscopic nephroureterectomy (HARNU).

A total of 54 patients who underwent HARNU were enrolled in the study. Patients were divided into two groups: Retroperitoneoscopic nephroureterectomy with hand port (traditional HARNU) and without hand port (gasless HARNU). Each group was then divided further based on whether body mass index (BMI) value was greater or less than 24 kg/m(2). Operative times, blood loss, and hospital stay were recorded and compared between traditional HARNU and gasless HARNU groups by two-paired Student t test and Wilcoxon sign rank test. These results were also compared between different BMI groups.

There were no open surgery conversions in this study. Only one patient needed repeated surgery because of urine leakage from the bladder cuff into the peritoneal space. No statistically significant differences existed in operative times, blood loss, and hospital stay between the hand port and no hand port groups in retroperitoneoscopic nephroureterectomy. Notably, no statistically significant differences existed regardless of whether BMI exceeded 24 kg/m(2) in each group.

Gasless retroperitoneoscopic nephroureterectomy proved that the surgery can be performed without a hand port. Obesity did not cause an increase in operative time and blood loss in this study. Therefore, gasless retroperitoneoscopic nephroureterectomy is safe and provides the alternative choice for nephroureterectomy.