Single Access Site Laparoscopic Radical Nephrectomy : Initial Clinical Experience

We present the initial clinical experience with single access site (SAS) laparoscopic radical nephrectomy. An 86-year-old woman presented with an 8-cm central-enhancing right renal lesion. The patient elected to undergo a laparoscopic radical nephrectomy. A 7-cm paramedian incision was made just lat...

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Veröffentlicht in:Journal of endourology 2008-04, Vol.22 (4), p.663-665
Hauptverfasser: PONSKY, Lee E, CHERULLO, Edward E, SAWYER, Mark, HARTKE, David
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container_end_page 665
container_issue 4
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container_title Journal of endourology
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creator PONSKY, Lee E
CHERULLO, Edward E
SAWYER, Mark
HARTKE, David
description We present the initial clinical experience with single access site (SAS) laparoscopic radical nephrectomy. An 86-year-old woman presented with an 8-cm central-enhancing right renal lesion. The patient elected to undergo a laparoscopic radical nephrectomy. A 7-cm paramedian incision was made just lateral to the left rectus muscle and cranial to the umbilicus. A GelPort was inserted into the incision. Three trocars (12 mm, 10 mm, and 5 mm) were placed through the access port, and only standard laparoscopic instruments were used. The kidney was mobilized in the standard fashion. Controlling the renal artery with nonabsorbable polymer clips and the renal vein with a stapling device, the specimen was manipulated into a laparoscopic retrieval bag and removed intact. Hemostasis was confirmed, the GelPort was removed, and the 7-cm incision was closed. The procedure was completed in 96 minutes without complications. Blood loss was estimated to be 10 mL. Postoperatively, the patient was treated with intermittent intravenous and oral analgesics. She was discharged on postoperative day 2 and tolerated a regular diet. This represents the initial report of an SAS laparoscopic radical nephrectomy, with intact specimen extraction. Using standard laparoscopic instrumentation, the procedure was performed safely and effectively, with minimal blood loss, and short hospitalization. Additional evaluation and development of this type of approach and instrumentation may allow for further expansion of SAS laparoscopic surgery in the future.
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She was discharged on postoperative day 2 and tolerated a regular diet. This represents the initial report of an SAS laparoscopic radical nephrectomy, with intact specimen extraction. Using standard laparoscopic instrumentation, the procedure was performed safely and effectively, with minimal blood loss, and short hospitalization. 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source MEDLINE; Alma/SFX Local Collection
subjects Aged, 80 and over
Biological and medical sciences
Care and treatment
Case studies
Diagnosis
Female
Health aspects
Humans
Kidney diseases
Laparoscopic surgery
Laparoscopy
Laparoscopy - methods
Medical sciences
Nephrectomy
Nephrectomy - methods
Nephrology. Urinary tract diseases
Patient outcomes
title Single Access Site Laparoscopic Radical Nephrectomy : Initial Clinical Experience
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