Hand-assisted laparoscopic versus laparoscopic nephrectomy as outpatient procedures: a prospective randomized study

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrology

Background:

• Laparoscopic nephrectomy (LNo) is a standard surgical approach for renal tumors.
• Outpatient procedures are increasingly explored to improve efficiency and patient convenience.
• Hand-assistance in laparoscopy may offer benefits in certain surgical scenarios.

Purpose of the Study:

• To evaluate the feasibility and safety of hand-assisted laparoscopic nephrectomy (HALNo) as an outpatient procedure.
• To compare HALNo with transperitoneal laparoscopic nephrectomy (LNo) in an outpatient setting.
• To assess the primary outcome of length of hospital stay (LOS) for both procedures.

Main Methods:

• A prospective, randomized study involving 30 patients with renal tumors.
• Patients were recruited between November 2014 and February 2016.
• Comparison of HALNo (15 patients) versus LNo (15 patients) with LOS as the primary endpoint.

Main Results:

• All 30 patients were discharged within 6 hours post-operation, regardless of surgical approach.
• Mean operation times were similar: 65±24 min for HALNo and 69±24 min for LNo (p=0.95).
• Mean postoperative care unit time and mean LOS were comparable between HALNo and LNo groups, with no statistically significant difference (p>0.53).

Conclusions:

• Hand-assisted laparoscopic nephrectomy (HALNo) is a safe and feasible outpatient option for carefully selected patients.
• HALNo demonstrates comparable postoperative length of hospital stay to transperitoneal laparoscopic nephrectomy (LNo).
• Outpatient HALNo offers a viable alternative for renal tumor surgery in appropriate patient populations.