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[Preliminary application of monopolar coagulation in suturelesslaparoscopic partial nephrectomy]
1Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Zhonghua Yi Xue Za Zhi
|January 7, 2017
Summary
Monopolar coagulation is a safe and feasible technique for sutureless laparoscopic partial nephrectomy (LPN). The off-clamped approach is recommended for exophytic and small renal tumors.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic partial nephrectomy (LPN) is a standard treatment for renal tumors.
- Sutureless techniques aim to reduce operative time and complications.
- Monopolar coagulation offers a potential method for hemostasis in sutureless LPN.
Purpose of the Study:
- To evaluate the safety and feasibility of monopolar coagulation in sutureless LPN.
- To assess outcomes including operative time, blood loss, and complications.
Main Methods:
- A prospective study of 25 patients undergoing sutureless LPN with monopolar coagulation.
- Tumor resection using cold scissors and monopolar hook; coagulation of tumor beds.
- Comparison of clamped versus off-clamped renal hilar vessels.
- Use of N-butyl-2-cyanoacrylate (NBCA) for bleeding control.
Main Results:
- Mean operative time was 129.6 minutes; mean estimated blood loss was 166 ml.
- Mean hospital stay was 16.2 days.
- Two patients experienced urine leakage; one required open surgery after embolization failure for hemorrhage.
Conclusions:
- Sutureless LPN using monopolar coagulation is a safe and feasible surgical option.
- The off-clamped technique is recommended for exophytic and smaller renal tumors.
