Conversion to hand assistance may prevent conversion to an open procedure in standard laparoscopic nephrectomy

Area of Science:

• Urologic surgery
• Minimally invasive techniques

Background:

• Laparoscopic surgery is widely adopted in urology.
• Conversion to open surgery during laparoscopy can negatively impact patients and surgeons.
• Hand-assisted laparoscopy offers an alternative to open conversion.

Purpose of the Study:

• To review the efficacy and safety of converting standard laparoscopy to hand-assisted laparoscopy.
• To evaluate hand-assisted laparoscopy as a method to avoid open conversion.

Main Methods:

• Retrospective review of laparoscopic nephrectomies performed by a single surgeon.
• Analysis of demographic and perioperative data.
• Detailed examination of cases requiring conversion from standard laparoscopy.

Main Results:

• 161 laparoscopic nephrectomies were performed.
• Conversion from standard laparoscopy was necessary in 6 cases (4%).
• Five of these conversions were successfully completed using hand assistance.
• Reasons for conversion included failure to progress (3) and hemostasis control (2).
• One patient required conversion to open surgery due to pneumoperitoneum intolerance.

Conclusions:

• Conversion to hand-assisted laparoscopy is a safe and effective option.
• Hand-assisted laparoscopy can successfully prevent conversion to open surgery in select cases.