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Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
Published on: August 8, 2025
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
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.
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).
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.
