Related Experiment Video
Updated: Oct 21, 2025
04:40
Bloodless Laparoscopic Partial Splenectomy Assisted by Bipolar Radiofrequency Excision Hemostatic Device
Published on: November 4, 2022
1.2K
Massive Hemorrhage during Retroperitoneal Laparoscopic Radical Nephrectomy: A Case Report
Masato Yanagi1, Tsutomu Hamasaki2, Jun Akatsuka1
1Department of Urology, Nippon Medical School Hospital.
Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi
|September 2, 2021
Summary
Retroperitoneal laparoscopic radical nephrectomy (LRN) carries risks. A case report highlights potential tumor vessel injury during port placement, suggesting the transperitoneal approach may be safer for lateral tumors.
Area of Science:
- Urologic Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic radical nephrectomy (LRN) is the standard surgical treatment for localized renal cell carcinoma.
- LRN can be performed via transperitoneal or retroperitoneal approaches, each with unique potential complications.
Observation:
- A complication occurred during retroperitoneal LRN in a 63-year-old woman with right renal cell carcinoma.
- Tumor vessels were inadvertently damaged by a balloon dilator during initial port placement, causing massive hemorrhage.
Findings:
- The hemorrhage necessitated conversion to a retroperitoneal laparotomy to control bleeding.
- Active bleeding had ceased by the time of laparotomy, attributed to balloon dilator injury to tumor vessels.
- The nephrectomy was completed successfully after hemorrhage control without further complications.
Implications:
- This case suggests the transperitoneal approach may offer improved safety over the retroperitoneal approach for laterally located renal tumors with significant vascularity.
- Careful port placement and awareness of potential complications are crucial in retroperitoneal LRN, especially with complex tumor anatomy.
