Hand-assisted laparoscopic partial nephrectomy by using an "open" device of microwave tissue coagulator

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Renal tumors necessitate surgical intervention, with partial nephrectomy being the preferred method for preserving kidney function.
• Laparoscopic partial nephrectomy offers benefits of minimally invasive surgery but can be technically challenging.
• Ensuring adequate hemostasis and minimizing collateral thermal damage are critical in renal tumor resection.

Purpose of the Study:

• To evaluate the safety and reproducibility of using an "open" microwave tissue coagulator (MTC) device for hand-assisted laparoscopic partial nephrectomy (HALPN).
• To assess the feasibility of performing HALPN with an MTC device without renal pedicle clamping.

Main Methods:

• Five patients with small, exophytic renal tumors underwent HALPN between July 2005.
• An "open" surgical MTC device was introduced into the abdominal cavity via a GelPort.
• Tumor coagulation was performed with the MTC, followed by resection using laparoscopic scissors and blunt dissection, without clamping the renal pedicle.

Main Results:

• HALPN was successfully completed in all five patients without requiring conversion to open surgery.
• Estimated blood loss was less than 100 mL in all cases.
• No postoperative complications, including urine leakage or loss of renal function, were observed.

Conclusions:

• The described technique using an "open" MTC device for HALPN is a safe and reproducible method for treating small renal tumors.
• This approach minimizes the risk of collateral thermal damage through precise needle puncture.
• The technique can be readily adopted by urologists, maintaining the benefits of minimally invasive surgery through a small incision.