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Laparoscopic Nephrectomy (laparoscopic + nephrectomy)
Selected AbstractsThe efficacy and safety of laparoscopic nephrectomy in patients with three or more comorbiditiesINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2007Yukio Naya Objectives: Laparoscopic surgery for kidney treatment is a common procedure. However, the efficacy of this procedure in patients with several comorbidities has not been well investigated. We conducted a retrospective comparison of results of laparoscopic surgery between patients with several comorbidities and patients with no comorbidity to access the efficacy and safety of this procedure. Methods: The subjects were 20 patients with three or more comorbidities (group A) and 46 patients with less than three comorbidities (group B). These 66 patients were 48 men and 18 women with a mean age of 62.3 years (age range, 24,83 years). The data from these two groups were compared for American Society of Anesthesiology (ASA) physical status score, previous surgical history, duration of surgery, estimated blood loss, tumor size, complications during and after surgery, conversion rates, time to oral intake, and length of hospital stay. Results: The initial ASA score and age were significantly higher for the patients with comorbidities (P < 0.0001, P = 0.0008, respectively). All other variables before, during, and after surgery were similar for both laparoscopic groups. However, the incidence of atelectasis of laparoscopy was higher than that of open surgery. Conclusions: Laparoscopic nephrectomy for patients with comorbidities is safe and minimally invasive. Further investigation to prevent atelectasis is necessary. [source] Retroperitoneoscopic pre-transplant native kidney nephrectomyINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2006RAJIV GOEL Aims:, Laparoscopic nephrectomy has become a standardized procedure for removal of benign non-functioning kidneys. We present our experience of retroperitoneoscopic pre-transplant native kidneys nephrectomy. Methods:, Comparison of 40 patients who underwent retroperitoneoscopy with 40 open simple pre-transplant nephrectomy patients was done. Results:, Forty retroperitoneoscopic nephrectomies were done between June 2003 and April 2005. The mean operative time was similar in the two groups; however, the mean blood loss, postoperative analgesic requirement, complication rate, hospital stay and convalescence period were significantly less in the retroperitoneoscopic group. Conclusion:, Retroperitoneoscopic nephrectomy should be offered as the primary treatment modality to patients requiring pre-transplant native kidney nephrectomy, except in patients where it is contraindicated. [source] Evaluation of the efficacy and safety of laparoscopic nephrectomyINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2001Kazuhiro Yoshimura AbstractPurpose: To evaluate the efficacy and safety of laparoscopic nephrectomy. Methods: From June 1994 to November 1999, 10 patients underwent laparoscopic nephrectomy at Osaka University Medical Hospital and Osaka Rosai Hospital. Laparoscopic nephrectomy was performed either via transperitoneal or retroperitoneal approach under general anesthesia. These 10 cases were reviewed in respect of primary disease of the kidney, operative time, complications and postoperative convalescence. Results: Of the 10 patients, five were preoperatively diagnosed as having a non-functioning kidney with hydronephrosis, two patients were diagnosed as having an atrophic kidney, two had renal cell carcinoma and one had renal pelvic tumor. The average operative time was 374 min (range 270,675 min). The mean blood loss was 330 mL (range 60,800 mL). One patient required transfusion due to postoperative oozing. The average hospital stay after operation was 7 days. No major postoperative complications were observed. Conclusion: Laparoscopic nephrectomy is an option in surgically managing renal disorders, including malignancies, although it has a longer operative time compared to conventional open surgery. [source] Complications and the learning curve for a laparoscopic nephrectomy at a single institutionINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2006TORU KANNO Background:, We assessed our experiences in performing a laparoscopic nephrectomy, with regard to complications and the learning curve, during a 4-year period. Methods:, Between November 2000 and October 2004, a total of 78 laparoscopic nephrectomies were performed at our institution (37 radical nephrectomies, 30 nephroureterectomies and 11 simple nephrectomies). The patient charts were retrospectively reviewed to identify any operative and postoperative complications, and also to evaluate the operating time. Results:, A total of eleven complications (14.1%) occurred in our series (nine operative and two postoperative complications). All operative complications were due to vascular injuries (n = 9), five (2.6%) of which required an open conversion. The operating time and the rates of complications decreased significantly as the surgeons' experiences increased. Conclusion:, A laparoscopic nephrectomy could be performed as safely as previously reported. In addition, the learning curve for a laparoscopic nephrectomy appeared to be good over the initial 50 procedures at our institution. [source] How to use laparoscopic surgical instruments safelyINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2009Eiji Higashihara The development of laparoscopic surgery has been accompanied by a rapid increase in the number of laparoscopic surgical procedures carried out in the field of urology. In 2002 laparoscopic nephrectomy was approved for coverage under Japanese national health insurance, and in 2003 there were over 1000 registered cases in which this procedure was carried out. This suggests that laparoscopic nephrectomy, a procedure formerly conducted at only a few institutions, is now spreading to hospitals across Japan. Laparoscopic surgery involves the use of specialized instruments within a restricted field of vision, and risky surgical techniques can potentially result in visceral or vascular damage. In order to promote the use of safe laparoscopic surgery procedures, the Japanese Urological Association and the Japanese Society of Endourology and Extracorporeal Shock Wave Lithotripsy (ESWL) have inaugurated a certification program for urologic laparoscopy. This program not only encourages development in this field of surgery and provides technical certification to ensure appropriate levels of expertise, but also reviews methods for the correct use of instruments such as trocars and hemostats. The purpose of this video is to present correct methods for the use of a variety of laparoscopic instruments, in order to increase the safety of this procedure. The video has been designed to be useful not only for practitioners who are just beginning laparoscopy, but also for those who already have extensive laparoscopic experience. The video discusses five laparoscopic instruments (trocar, electric surgical devices, ultrasonic surgery devices, clips and clip appliers and endo-staplers), and demonstrates their correct use. In addition, animal models are used to illustrate the potential complications that can be associated with some methods of use. [source] Comparison of transperitoneal and retroperitoneal laparoscopic nephrectomy for renal cell carcinoma: A single-center experience of 100 casesINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2008Takatsugu Okegawa Objectives: To report our experience with the retroperitoneal and transperitoneal approaches of laparoscopic nephrectomy for renal cell carcinoma (RCC). Methods: Between July 2001 and December 2007, 100 patients with RCC underwent laparoscopic radical nephrectomy at our institution for clinically localized RCC. Fifty-three patients received a retroperitoneal procedure and 47 received a transperitoneal procedure. The perioperative and oncological outcomes of these groups were reviewed retrospectively. Results: Mean follow up was 34 months. No statistically significant difference was found between the two approaches in terms of pathological stage, operative time, need for additional procedures such as adrenalectomy and/or lymph node sampling, estimated blood loss, need for blood transfusions, analgesic requirement, length of hospital stay, or the incidence of minor or major complications. The 5-year disease-free survival rate was 90% for both the retroperitoneal and transperitoneal procedures. The 5-year overall survival rates were 98% and 96%, respectively. Therefore, no significant difference was observed in the long-term oncological outcome between the two groups. Conclusions: Tumor control and surgical morbidity in laparoscopic radical nephrectomy seem not to be significantly influenced by the approach. [source] The efficacy and safety of laparoscopic nephrectomy in patients with three or more comorbiditiesINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2007Yukio Naya Objectives: Laparoscopic surgery for kidney treatment is a common procedure. However, the efficacy of this procedure in patients with several comorbidities has not been well investigated. We conducted a retrospective comparison of results of laparoscopic surgery between patients with several comorbidities and patients with no comorbidity to access the efficacy and safety of this procedure. Methods: The subjects were 20 patients with three or more comorbidities (group A) and 46 patients with less than three comorbidities (group B). These 66 patients were 48 men and 18 women with a mean age of 62.3 years (age range, 24,83 years). The data from these two groups were compared for American Society of Anesthesiology (ASA) physical status score, previous surgical history, duration of surgery, estimated blood loss, tumor size, complications during and after surgery, conversion rates, time to oral intake, and length of hospital stay. Results: The initial ASA score and age were significantly higher for the patients with comorbidities (P < 0.0001, P = 0.0008, respectively). All other variables before, during, and after surgery were similar for both laparoscopic groups. However, the incidence of atelectasis of laparoscopy was higher than that of open surgery. Conclusions: Laparoscopic nephrectomy for patients with comorbidities is safe and minimally invasive. Further investigation to prevent atelectasis is necessary. [source] Control of the large renal vein in limited dissected space during laparoscopic nephrectomy: A simple and reliable methodINTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2006KITTINUT KIJVIKAI Abstract, We describe our technique for large renal vein control in the limited dissected space during laparoscopic nephrectomy. This technique is a simple, inexpensive and reliable method, especially for large and short renal vein ligation. [source] Complications and the learning curve for a laparoscopic nephrectomy at a single institutionINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2006TORU KANNO Background:, We assessed our experiences in performing a laparoscopic nephrectomy, with regard to complications and the learning curve, during a 4-year period. Methods:, Between November 2000 and October 2004, a total of 78 laparoscopic nephrectomies were performed at our institution (37 radical nephrectomies, 30 nephroureterectomies and 11 simple nephrectomies). The patient charts were retrospectively reviewed to identify any operative and postoperative complications, and also to evaluate the operating time. Results:, A total of eleven complications (14.1%) occurred in our series (nine operative and two postoperative complications). All operative complications were due to vascular injuries (n = 9), five (2.6%) of which required an open conversion. The operating time and the rates of complications decreased significantly as the surgeons' experiences increased. Conclusion:, A laparoscopic nephrectomy could be performed as safely as previously reported. In addition, the learning curve for a laparoscopic nephrectomy appeared to be good over the initial 50 procedures at our institution. [source] Evaluation of the efficacy and safety of laparoscopic nephrectomyINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2001Kazuhiro Yoshimura AbstractPurpose: To evaluate the efficacy and safety of laparoscopic nephrectomy. Methods: From June 1994 to November 1999, 10 patients underwent laparoscopic nephrectomy at Osaka University Medical Hospital and Osaka Rosai Hospital. Laparoscopic nephrectomy was performed either via transperitoneal or retroperitoneal approach under general anesthesia. These 10 cases were reviewed in respect of primary disease of the kidney, operative time, complications and postoperative convalescence. Results: Of the 10 patients, five were preoperatively diagnosed as having a non-functioning kidney with hydronephrosis, two patients were diagnosed as having an atrophic kidney, two had renal cell carcinoma and one had renal pelvic tumor. The average operative time was 374 min (range 270,675 min). The mean blood loss was 330 mL (range 60,800 mL). One patient required transfusion due to postoperative oozing. The average hospital stay after operation was 7 days. No major postoperative complications were observed. Conclusion: Laparoscopic nephrectomy is an option in surgically managing renal disorders, including malignancies, although it has a longer operative time compared to conventional open surgery. [source] Risk factors and prevention of rhabdomyolysis after laparoscopic nephrectomyBJU INTERNATIONAL, Issue 5 2006Shafaque Shaikh No abstract is available for this article. [source] 46 Laparoscopic versus open living donor nephrectomy: a contemporary series from a single centreBJU INTERNATIONAL, Issue 2006R.E. POWER Introduction:, Laparoscopic living donor nephrectomy offers potential advantages to the donor and has become a routine procedure for live kidney procurement worldwide. Since 2000 our live donor patients have been offered a laparoscopic nephrectomy. Patients and Methods:, Between February 2000 and August 2005 we performed 183 donor-recipient operations at our institution (ODN = 83 and LND = 100). We prospectively collected information on all donors and recipients for the same period to audit our experience with the first 100 LDN,s. Patients made their operative choice following discussions regarding the unit experience and literature information. We present our findings with specific emphasis on donor operative details and early recipient graft outcome. Results:, Donor and recipient age, gender, body mass index, HLA mismatches, warm ischaemia and vascular anastomotic times did not significantly differ between the two groups. There were two conversions to an open operation in the LND group and neither impacted upon recipient graft outcome. The mean operative duration was 178 ± 38 for the LDN and 159 ± 34 min for the ODN (P < 0.05). The mean length of hospital stay was 4.7 ± 1.2 days in the LND group versus 6.8 ± 1.5 days in the ODN group (P < 0.05). There was one case of delayed graft function in both groups. Serum creatinine at 1, 6 and 12 months did not differ significantly between either groups. Vascular and ureteric complications and lymphocoele rates were similar in both groups. Conclusions:, Our contemporaneous series demonstrates the safe introduction of a laparoscopic living donor programme without compromise towards donor patient safety or allograft outcome. [source] Laparoscopic radical nephrectomy for T1 renal cancer: the gold standard?BJU INTERNATIONAL, Issue 1 2004A comparison of laparoscopic vs open nephrectomy OBJECTIVE To evaluate the complication rate and clinical follow-up of patients treated for T1 renal cancer by open or laparoscopic nephrectomy at the same institution, as this approach appears to be attractive for treating small renal cancers. PATIENTS AND METHODS Between 1995 and 2002, 39 patients underwent retroperitoneal laparoscopic and 26 transperitoneal open radical nephrectomy for T1 renal cancer (TNM 1997). Variables before during and after surgery, e.g. cancer recurrence, were compared between the groups. RESULTS There were no differences between the laparoscopic and open groups in age, sex ratio, weight, height, fitness score, operative duration (134 vs 133 min), minor or major complications, tumour diameter, Fuhrman grade or length of follow-up. Patients who underwent laparoscopic surgery had less blood loss (133 vs 357 mL, P < 0.001), less need for transfusion (none vs 150 mL, P = 0.04), a lower consumption of analgesia drugs, and shorter hospitalization (5.5 vs 8.8 days, P < 0.001). With a mean follow-up of 20.4 months there was no recurrence or tumour progression. CONCLUSION Laparoscopic radical nephrectomy for patients with T1 renal cancer is a safe, reliable procedure that decreases hospitalization time and bleeding, and ensures the same cancer control as open nephrectomy. [source] | ||||||||||