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Comparative evaluation of different specimen extraction techniques in laparoscopic simple nephrectomy in female
Jeena Kudunthail1, Mahendra Singh2, Deepak Bhirud1
1Department of Urology, All India Institute of Medical Sciences, Jodhpur, India.
Objective:
To compare different specimen extraction techniques in laparoscopic simple nephrectomy among female patients, focusing on perioperative outcomes, complications, and postoperative recovery.
Methods:
A retrospective analysis was conducted on data from 45 female patients who underwent laparoscopic nephrectomy between September 2022 and July 2024. Patients were divided into three groups: laparoscopic transperitoneal nephrectomy with transvaginal extraction (LTN-TVS), Pfannenstiel extraction (LTN-PFN), and retroperitoneoscopic nephrectomy (RPN) with flank extraction. Demographic data, operative details, extraction times, postoperative outcomes, and sexual function scores were analyzed.
Results:
The LTN-PFN group had the shortest operative (106.93 ± 20.89 min) and extraction times (18.00 ± 2.97 min) compared to LTN-TVS (127.80 ± 27.88 min, 30.13 ± 8.05 min) and RPN (130.8 ± 32.62 min, 18.93 ± 16.35 min) groups (P < 0.05). Initially longer extraction times were seen in the transvaginal group which decreased with experience. The LTN-TVS group had significantly lower pain scores at 24 and 48 h and reduced analgesic needs (P < 0.01) as compared to other groups. Scar assessment scores favored the transvaginal group. Incisional hernias occurred in 2 PFN and 1 RPN patient, but none in the TVS group. Hospital stay, pelvic floor, and sexual function scores showed no significant differences among the groups.
Conclusion:
The transvaginal extraction method offers a promising, minimally invasive alternative with superior postoperative outcomes and minimal complications, making it a preferred approach in female patients undergoing laparoscopic nephrectomy.
