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Updated: May 24, 2026

Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
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Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach

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Minimally invasive heminephrectomy: feasibility and outcomes.

Steven Sobey1, A Ari Hakimi, David Faleck

  • 1Department of Urology, Montefiore Medical Center, Bronx, New York 10467, USA. ssobey@montefiore.org

Journal of Endourology
|February 25, 2012
PubMed
Summary

Laparoscopic heminephrectomy (LHN) effectively treats larger, complex kidney tumors. While operative and clamp times increase, LHN shows no adverse impact on recovery or renal function.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Oncology

Background:

  • Laparoscopic partial nephrectomy (LPN) is standard for renal tumors.
  • Increasing surgeon expertise allows LPN for larger, complex renal malignancies.
  • Laparoscopic heminephrectomy (LHN) involves resecting over 30% of the kidney.

Purpose of the Study:

  • To describe the technique and outcomes of LHN.
  • To evaluate LHN for complex renal tumors.
  • To assess complications, renal function, and perioperative results of LHN.

Main Methods:

  • Retrospective review of 145 patients undergoing LPN.
  • Analysis of 24 patients who underwent LHN.
  • Parameters included tumor size, nephrometry score, operative time, clamp time, EBL, LOS, renal function, and complications (Clavien system).

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Main Results:

  • LHN patients had larger tumors (4.7 vs 2.6 cm) and higher complexity scores (6.6 vs 5.0).
  • Operative time (176.0 vs 151.6 min) and clamp time (29.3 vs 21.9 min) were significantly increased in LHN.
  • No significant differences were observed in LOS, EBL, renal function change, or complication rates.

Conclusions:

  • Laparoscopic heminephrectomy (LHN) is an efficacious and feasible approach for complex renal tumors.
  • Despite increased operative and clamp times, LHN does not negatively impact length of stay, blood loss, renal function, or complication rates.