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Laparoscopic renal surgery is here to stay
Angus Chin On Luk1, Rajadoss Muthu Krishna Pandian1, Rakesh Heer1
1Department of Urology, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK.
Arab Journal of Urology
|August 25, 2018
Summary
Comparing open, laparoscopic, and robotic renal surgery, evidence suggests similar oncological outcomes. Laparoscopic and robotic approaches offer faster recovery, but robotic surgery provides no clear benefit over laparoscopic despite higher costs.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Renal surgery encompasses open, laparoscopic, and robotic techniques.
- Choosing the optimal approach impacts patient outcomes and resource utilization.
Purpose of the Study:
- To compare the functional and oncological outcomes of renal surgery across open, laparoscopic, and robotic approaches.
- To evaluate complications, recovery times, and cost-effectiveness.
Main Methods:
- A comprehensive literature search was conducted using PubMed, MEDLINE, and Ovid.
- Studies comparing open, laparoscopic, and robotic renal surgery outcomes were systematically reviewed.
Main Results:
- All three surgical approaches demonstrate comparable functional and oncological outcomes.
- Laparoscopic and robotic surgeries show reduced blood loss, lower analgesic requirements, shorter hospital stays, and quicker recovery compared to open surgery.
- Complication rates are similar across all approaches; robotic surgery offers no significant clinical advantage over laparoscopy but incurs higher costs.
Conclusions:
- Laparoscopic renal surgery remains a relevant and effective option for various urological conditions.
- The high cost and lack of demonstrable clinical superiority of robotic surgery warrant careful consideration in its adoption.
Keywords:
(L)(LESS-)DN, (laparoscopic) (laparoendoscopic single-site-) donor nephrectomy(L)(O)(RA)PN, (laparoscopic) (open) (robot-assisted) partial nephrectomy(L)(O)(RA)PY, (laparoscopic) (open) (robot-assisted) pyeloplasty(L)(O)(RA)RN, (laparoscopic) (open) (robot-assisted) radical nephrectomyBMI, body mass indexDonor nephrectomyLOS, length of hospital stayLaparoscopic/open/robotic renal surgeryNOTES, natural orifice transluminal endoscopic surgeryPUJO, PUJ obstructionPartial nephrectomyPyeloplastyRCT, randomised controlled trialRadical nephrectomyWIT, warm ischaemia timeeGFR, estimated GFR
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