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A novel mini-retractor for retroperitoneal laparoscopic partial nephrectomy.

Xuwei Lu^1,2, Zhuifeng Guo², Guanwen Yang¹

¹Department of Urology, Zhongshan Hospital, FUDAN University, Shanghai, China.

Journal of Surgical Oncology

|April 12, 2024

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Mini-lap, a novel retractor, enhances retroperitoneal partial nephrectomy (RLPN) by improving workspace and surgical vision. This technique successfully completed 51 RLPN cases with minimal complications, demonstrating its feasibility.

Area of Science:

Minimally Invasive Surgery
Urologic Oncology
Surgical Technology

Background:

Retroperitoneal partial nephrectomy (RLPN) is standard for localized renal tumors but faces challenges due to limited surgical space.
Existing methods to improve RLPN access are still under investigation.

Purpose of the Study:

To evaluate the feasibility and effectiveness of using the Mini-lap system as a novel retractor in RLPN.
To assess its impact on surgical workspace and vision.

Main Methods:

A multicenter retrospective review included 51 patients undergoing RLPN with the Mini-lap system between January 2018 and December 2020.
Standard three-port RLPN was performed, utilizing the Mini-lap (Teleflex Minilap percutaneous Surgical System) as a key retractor.
Preoperative, intraoperative, and postoperative outcomes were analyzed.

Keywords:

laparoscopy partial nephrectomy retractor retroperitoneal

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Main Results:

All 51 RLPN procedures were completed successfully using the Mini-lap system without conversion to open surgery.
The average tumor diameter was 3.53 cm, with 62.7% located anteriorly.
Mean operative time was 86.7 minutes, and mean warm ischemia time was 25.6 minutes.
Minor complications (Clavien grade 1-2) were observed in 6 patients.

Conclusions:

The Mini-lap system serves as an effective mini-retractor for RLPN, potentially reducing the need for additional assistant ports.
It demonstrably expands the surgical workspace and optimizes visualization during retroperitoneal laparoscopic partial nephrectomy.
The study highlights the system's applicability in improving surgical efficiency and outcomes in RLPN.