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LAPAROSCOPY‐ASSISTED RADICAL NEPHRECTOMY IN COMBINATION WITH MINILAPAROTOMY: REPORT OF INITIAL 7 CASES
Author(s) -
Nishiyama Tsutomu,
Terunurna Masahiro
Publication year - 1995
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1995.tb00438.x
Subject(s) - medicine , nephrectomy , convalescence , umbilicus (mollusc) , laparoscopy , pneumoperitoneum , surgery , fascia , insufflation , kidney , endocrinology
We recently developed a new procedure for laparoscopy‐assisted radical nephrectomy in combination with minilaparotomy to remove kidneys with renal cell carcinoma. A pararectal incision approximately 7 cm in length was performed from the subcostal region. A 12‐mm trocar was placed at the mid‐clavicular line at the level of the umbilicus. An 11 ‐mm trocar was placed at the tip of the rib. Under laparoscopic and trans‐minilaparotomic observation, intra‐abdominal manipulation was begun. The contents of Gerota's fascia were freed from the surrounding tissues and removed through the abdominal incision. Seven patients have been successfully treated with this procedure. The operating time for this procedure was shorter than the time of laparoscopic nephrectomy. There were none of the adverse hemodynamic or ventilatory effects associated with pneumoperitoneum in this procedure. This procedure also resulted in less postoperative pain and a shorter convalescence period when compared with open nephrectomy.