Laparoendoscopic single-site partial nephrectomy without hilar clamping using a microwave tissue coagulator

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Partial nephrectomy is the standard treatment for small renal masses.
• Minimally invasive techniques aim to reduce morbidity and improve cosmesis.
• Laparoendoscopic single-site (LESS) surgery offers potential advantages over conventional laparoscopic surgery.

Purpose of the Study:

• To evaluate the feasibility and initial outcomes of nonhilar clamp LESS partial nephrectomy using a microwave tissue coagulator.
• To assess the safety and efficacy of this novel surgical approach for small renal masses.

Main Methods:

• Seven patients with small (≤4.0 cm) exophytic renal masses underwent nonhilar clamp LESS partial nephrectomy.
• A multichannel port and a rigid, articulating apparatus were used for tumor dissection, coagulation, and resection.
• Pathologic, hematologic, pain, and scar data were analyzed.

Main Results:

• The procedure was successfully performed in six patients; one required conversion to conventional laparoscopy due to bleeding.
• Mean operative time was 208 minutes, and mean blood loss was 39 mL.
• No transfusions were needed, and patients reported minimal pain and high satisfaction with cosmetic results.

Conclusions:

• Nonhilar clamp LESS partial nephrectomy with a microwave tissue coagulator is a viable option for selected renal masses.
• This technique provides comparable postoperative outcomes to standard partial nephrectomy while enhancing patient satisfaction and cosmesis.
• The use of a microwave tissue coagulator facilitates single-port access, reducing invasiveness.