scholarly journals Multicenter Experience with Nonischemic Multiport Laparoscopic and Laparoendoscopic Single-Site Partial Nephrectomy Utilizing Bipolar Radiofrequency Ablation Coagulator

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Wassim M. Bazzi ◽  
Mohamad E. Allaf ◽  
Jared Berkowitz ◽  
Hany N. Atalah ◽  
Sijo Parekattil ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Tumor Size ◽  
Operative Time ◽  
Single Site ◽  
Laparoendoscopic Single Site ◽  
Bipolar Radiofrequency ◽  
Estimated Blood Loss ◽  
Multicenter Retrospective Review ◽  
Term Data

Objective. To investigate feasibility of multiport and laparoendoscopic single-site (LESS) nonischemic laparoscopic partial nephrectomy (NI-LPN) utilizing bipolar radiofrequency coagulator. Methods. Multicenter retrospective review of 60 patients (46 multiport/14 LESS) undergoing NI-LPN between 4/2006 and 9/2009. Multiport and LESS NI-LPN utilized Habib 4X bipolar radiofrequency coagulator to form a hemostatic zone followed by nonischemic tumor excision and renorrhaphy. Demographics, tumor/perioperative characteristics, and outcomes were analyzed. Results. 59/60 (98.3%) successfully underwent NI-LPN. Mean tumor size was 2.35 cm. Mean operative time was 160.0 minutes. Mean estimated blood loss was 131.4 mL. Preoperative/postoperative creatinine (mg/dL) was 1.02/1.07 (). All had negative margins. 12 (20%) patients developed complications. 3 (5%) developed urine leaks. No differences between multiport and LESS-PN were noted as regards demographics, tumor size, outcomes, and complications. Conclusion. Initial experience demonstrates that nonischemic multiport and LESS-PN is safe and efficacious, with excellent short-term preservation of renal function. Long-term data are needed to confirm oncological efficacy.

scholarly journals Patient-reported satisfaction and cosmesis outcomes following laparoscopic adrenalectomy: laparoendoscopic single-site adrenalectomy vs. conventional laparoscopic adrenalectomy

2014 ◽  
Vol 8 (1-2) ◽  
pp. 20 ◽  
Author(s):  
Shogo Inoue ◽  
Kenichiro Ikeda ◽  
Kanao Kobayashi ◽  
Mitsuru Kajiwara ◽  
Jun Teishima ◽  
...  
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Young Patients ◽  
Satisfaction Score ◽  
Single Site ◽  
Female Patients ◽  
Conventional Laparoscopic ◽  
Laparoendoscopic Single Site ◽  
Estimated Blood Loss ◽  
Patient Reported

Introduction: We evaluate patient-reported satisfaction and cosmesis of laparoendoscopic single-site adrenalectomy (LESS-A) in comparison with that of conventional laparoscopic adrenalectomy (CLA).Methods: A total of 19 and 104 patients who respectively underwent LESS-A and CLA between May 1996 and June 2011 were included in the study. Questionnaires inquiring about scar pain (0: not painful, 10: very painful), satisfaction (0: not satisfied, 10:very satisfied) and cosmesis (0: very unsightly, 10: very beautiful) on the basis of a visual analogue scale were sent to patients postoperatively.Results: The respondents consisted of 11 and 54 patients who underwent LESS-A and CLA, respectively. There was no significant inter-group difference in age, sex, affected side or body mass index. No significant differences were observed in operative time or estimated blood loss. There were also no significant differences in pain (0.67 vs. 0.57, p = 0.393), satisfaction (8.92 vs. 8.46, p = 0.453), or cosmesis score (8.58 vs. 8.00, p = 0.487) between the LESS-A and CLA groups overall. In female patients, the satisfaction score was significantly higher in the LESS-A group than in the CLA group (10.0 vs. 8.72, p = 0.049). In young patients (<50 years old), the satisfaction score was also significantly higher in the LESS-A group than in the CLA group (9.17 vs. 6.38, p = 0.036).Conclusions: Young patients and female patients who had received LESS-A adrenal surgery were more satisfied with the scar outcomes than were the young patients and female patients who had received CLA. We suggest that this patient subset most values the cosmetic benefits of LESS-A.

scholarly journals Laparoendoscopic Single-Site Surgery (LESS) for a Large Ovarian Tumour: First Clinical Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Yao Dong Chua ◽  
Ying Woo Ng ◽  
Yoke Fai Fong
Keyword(s):  
Case Report ◽  
Operative Time ◽  
Ovarian Tumour ◽  
Single Site ◽  
Laparoscopic Technique ◽  
Technical Adequacy ◽  
Laparoendoscopic Single Site ◽  
Laparoscopic Instruments ◽  
Estimated Blood Loss ◽  
Laparoendoscopic Single Site Surgery

Objective. To report the feasibility of removing a 10 cm ovarian fibroma via a laparoendoscopic single-site trocar through trans-umbilical access.Design. Case report.Setting. Teaching and research hospital.Patient. A 64-year-old patient affected by a large 10 cm ovarian tumour.Intervention(s). Bilateral salpingo-oophorectomy a large 10 cm ovarian tumour, using a laparoendoscopic single-site approach with a Covidien SILS multitrocar access device and standard laparoscopic instruments.Main Outcome Measure(s). Conversion to standard laparoscopic technique or laparotomy, estimated blood loss, operative time , extent of scarring, occurrence of intra- and perioperative surgical complications, technical adequacy, and clinical outcome.Result(s). No conversion to standard laparoscopic technique or laparotomy, and no intraoperative or postoperative complications were observed. Total operative time was 99 minutes. The patient was discharged home on postoperative day one.Conclusion(s). Laparoendoscopic single-site bilateral salpingo-oophorectomy of a large ovarian tumour is feasible with standard laparoscopic instruments. It is safe and effective, with good results in terms of excellent cosmesis and minimal postoperative pain.

Laparoendoscopic Single-Site Partial Nephrectomy Without Hilar Clamping Using a Microwave Tissue Coagulator

2014 ◽  
Vol 28 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Noriyasu Kawai ◽  
Takahiro Yasui ◽  
Yukihiro Umemoto ◽  
Yasue Kubota ◽  
Kentaro Mizuno ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Single Site ◽  
Laparoendoscopic Single Site ◽  
Microwave Tissue Coagulator

Clampless laparoendoscopic single-site partial nephrectomy for renal cancer with low PADUA score: technique and surgical outcomes

2013 ◽  
Vol 111 (7) ◽  
pp. 1091-1098 ◽  
Author(s):  
Christopher Springer ◽  
Domenico Veneziano ◽  
Florian Wimpissinger ◽  
Antonino Inferrera ◽  
Paolo Fornara ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Renal Cancer ◽  
Surgical Outcomes ◽  
Single Site ◽  
Laparoendoscopic Single Site

scholarly journals Transumbilical laparoendoscopic single-site partial nephrectomy using a microwave tissue coagulator

2012 ◽  
Vol 1 (3) ◽  
pp. 176-179 ◽  
Author(s):  
Gou Kaneko ◽  
Akira Miyajima ◽  
Masanori Hasegawa ◽  
Eiji Kikuchi ◽  
Ken Nakagawa ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Single Site ◽  
Laparoendoscopic Single Site ◽  
Microwave Tissue Coagulator

scholarly journals Retroperitoneal hand-assisted laparoscopic nephrectomy and partial nephrectomy

2013 ◽  
Vol 3 (1) ◽  
pp. 3 ◽  
Author(s):  
Nosratollah Nezakatzgoo ◽  
Janet Colli ◽  
Matthew Mutter ◽  
Sheg Aranmolate ◽  
Robert Wake
Keyword(s):  
Partial Nephrectomy ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Oral Intake ◽  
Pathological Examination ◽  
Tumor Diameter ◽  
Renal Masses ◽  
Estimated Blood Loss ◽  
Average Operative Time

The purpose of the present paper is to describe our technique and experience with retroperitoneal hand-assisted laparoscopic (HAL) nephrectomies as an alternative to the transperitoneal approach. Eight retroperitoneal HAL nephrectomies and one partial nephrectomy were performed. Several excisional techniques were employed incorporating the Harmonic scalpel or Ligasure device. Hemostatic agents were used to cover the renal defect. Surgical bolsters were sutured to the renal capsule with pleget reinforcements to aid in hemostasis. The average operative time was 210 min and estimated blood loss 110 mL. Mean change in hematocrit was 3 units and creatinine was 1 point. No patient required a transfusion. There were no major complications, with a mean follow-up of fourteen months. On average, patients resumed oral intake in 2 days, and were discharged in 3 days. Pathological examination revealed that two lesions were benign and seven malignant. Tumor diameter averaged 3 cm. There were no positive surgical margins. In conclusion, we have demonstrated the feasibility of retroperitoneal laparoscopic hand-assisted nephrectomy and partial nephrectomy surgery for solid renal masses.

scholarly journals Robotic partial nephrectomy for renal tumours in obese patients: Perioperative outcomes in a multi-institutional analysis

2015 ◽  
Vol 9 (11-12) ◽  
pp. 859 ◽  
Author(s):  
Newaj Abdullah ◽  
Deepansh Dalela ◽  
Ravi Barod ◽  
Jeff Larson ◽  
Michael Johnson ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Blood Loss ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Independent Predictor ◽  
Operating Time ◽  
Perioperative Outcomes ◽  
Robotic Partial Nephrectomy ◽  
Obese Patients ◽  
Estimated Blood Loss

<p><strong>Introduction: </strong>We sought to evaluate the association of obesity with surgical outcomes of robotic partial nephrectomy (RPN) using a large, multicentre database.<strong> </strong></p><p><strong>Methods: </strong>We identified 1836 patients who underwent RPN from five academic centres from 2006-2014.  A total of 806 patients were obese (body mass index [BMI] ≥30 kg/m<sup>2</sup>). Patient characteristics and outcomes were compared between obese and non-obese patients. Multivariable analysis was used to assess the association of obesity on RPN outcomes.</p><p><strong>Results: </strong>A total of 806 (44%) patients were obese with median BMI of 33.8kg/m<sup>2</sup>. Compared to non-obese patients, obese patients had greater median tumour size (2.9 vs. 2.5 cm, p&lt;0.001), mean RENAL nephrometry score (7.3 vs. 7.1, p = 0.04), median operating time (176 vs. 165 min, p=0.002), and median estimated blood loss (EBL, 150 vs. 100 ml, p=0.002), but no difference in complications. Obesity was not an independent predictor of operative time or EBL on regression analysis. Among obese patients, males had a greater EBL (150 vs. 100 ml, p&lt;0.001), operative time (180 vs. 166 min, p&lt;0.001) and warm ischemia time (WIT, 20 vs. 18, p=0.001) and male sex was an independent predictor of these outcomes on regression analysis.</p><p><strong>Conclusion: </strong>In this large, multicentre study on RPN, obesity was not associated with increased complications and was not an independent predictor of operating time or blood loss.  However, in obese patients, male gender was an independent predictor of greater EBL, operative time, and WIT.  Our results indicate that obesity alone should not preclude consideration for RPN.<strong></strong></p>

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

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