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Related Experiment Videos

Hand assisted laparoscopic nephrectomy: comparison to standard laparoscopic nephrectomy

J S Wolf1, T D Moon, S Y Nakada

  • 1Department of Surgery, University of Michigan, Ann Arbor, USA.

The Journal of Urology
|June 17, 1998
PubMed
Summary

Hand assisted laparoscopic nephrectomy (HALN) offers improved operative speed and safety compared to standard laparoscopic nephrectomy (SLN). HALN is beneficial for complex cases and when intact specimens are needed, enhancing minimally invasive surgery.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Techniques

Background:

  • Laparoscopic nephrectomy is a minimally invasive approach for kidney removal.
  • Standard laparoscopic nephrectomy (SLN) utilizes laparoscopic instruments alone.
  • Hand assisted laparoscopic nephrectomy (HALN) incorporates a surgeon's hand intra-abdominally alongside laparoscopic instruments.

Purpose of the Study:

  • To report initial experiences with hand assisted laparoscopic nephrectomy (HALN).
  • To compare the outcomes of HALN with standard laparoscopic nephrectomy (SLN).

Main Methods:

  • A retrospective review of 21 cases (13 HALN, 8 SLN) including simple and radical nephrectomies, and nephroureterectomies.
  • HALN involved intra-abdominal hand placement via Pneumo Sleeve plus laparoscopic instruments.

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  • SLN used laparoscopic instruments exclusively.
  • Prospective data collection included operative time, complications, hospital stay, return to activity, and pain scores for 17 patients.

    • Main Results:

    • HALN demonstrated significantly shorter operative times (240 min) compared to SLN (325 min) (p=0.04).
    • Major complications were less frequent in the HALN group (8%) versus the SLN group (38%), though not statistically significant (p=0.10).
    • Hospital stay, return to normal activity, and 2-week pain scores were similar between both groups.

    Conclusions:

    • Hand assistance enhances operative speed and safety in laparoscopic nephrectomy without compromising minimally invasive benefits.
    • HALN may broaden the appeal of laparoscopic nephrectomy for surgeons with less advanced laparoscopic experience.
    • HALN is particularly advantageous for complex pathological conditions and when intact specimen retrieval is necessary, improving manipulative ability and tactile feedback.