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Comfortable suture angle with optimized trocar position aids renorrhaphy during retroperitoneal laparoscopic partial
Jian Qian1, Qian Zhang1, Qiang Cao1
1Department of Urology, First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Translational Andrology and Urology
|April 14, 2021
Summary
A comfortable suture angle (CSA) with optimized trocar positioning improves renorrhaphy during retroperitoneal laparoscopic partial nephrectomy (LPN). This technique is feasible, safe, and reduces operative time, particularly for specific tumor locations and R.E.N.A.L. nephrometry scores.
Area of Science:
- Urology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Retroperitoneal laparoscopic partial nephrectomy (LPN) involves complex renorrhaphy.
- Optimizing suture techniques is crucial for effective defect closure.
Purpose of the Study:
- To investigate a comfortable suture angle (CSA) with optimized trocar positioning for renorrhaphy in LPN.
- To determine the feasibility, usefulness, and safety of this approach for various tumor types.
Main Methods:
- Two optimized trocar positions were developed based on tumor characteristics.
- CSA was determined through surgical simulations and applied in 106 LPN patients.
- Data on patient characteristics, operative features, and follow-up were collected and analyzed.
Main Results:
- A CSA was successfully achieved in 83.96% of patients, leading to faster suture, clamping, and overall operative times compared to non-CSA cases.
- Estimated blood loss, surgical margin positivity, and renal function decline were similar between groups.
- Tumor location and R.E.N.A.L. nephrometry score (RNS) were identified as independent factors influencing CSA achievement.
Conclusions:
- Implementing a CSA with optimized trocar positioning is a feasible and safe method to simplify renorrhaphy during LPN.
- This technique can reduce operative time without compromising surgical outcomes.
- Tumor characteristics, specifically location and RNS, are key considerations for successful CSA application.
