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KMID : 1001020130110020089
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Korean Journal of Urological Oncology
2013 Volume.11 No. 2 p.89 ~ p.93
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Initial Experience of Hand-Assisted Laparoscopic Partial Nephrectomy Using Finger-tip Dissection Technique
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Lee Young-Ik
Kim Dae-Hyun
Kim Ji-Won
Ham Dong-Yeub
Bae Sang-Rak
Park Hyoung-Keun
Kim Hyeong-Gon
Lho Yong-Soo
Paick Sung-Hyun
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Abstract
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Purpose: We reported the initial experience of hand-assisted laparoscopic partial nephrectomy (HALPN) for kidney neoplasm using finger-tip dissection technique.
Materials and Methods: A total 11 patients with exophytic renal mass who had undergone HALPN for kidney neoplasms. After mobilizing the entire hilum thoroughly, the renal artery was hung with a rubber catheter. When massive bleeding occurred, it was clamped. Surgeon’s index finger-tip was used for the mass dissection. After making the incision line 5-10mm from the mass using scissors, the resection plane was gradually deepened bluntly by the finger-tip, which was directed centrally along the grain of the renal pyramids. If large vessels and calyxes were felt by the finger-tip during dissection, they were secured by clipping. The mass was completely removed by pinching off using the fingers.
Results: Mean patient age was 51.4 years (37-72 years), mean tumor size was 2.1cm (1.0-3.0cm), the mean operation time was 163.4min (120-310min). In only five patients, renal artery was clamped. In these cases, mean ischemic time was 24min (15-30min). All patients had negative resection margins. Mean estimated blood loss was 304.8ml (63-900ml) and two patients required a post-operative blood transfusion. No serious complications occurred.
Conclusions: The finger-tip dissection technique of renal mass in HALPN is feasible. This technique can allow the easy and safe dissection by the maximizing the tactile sense.
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KEYWORD
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Nephrectomy, Hand-assisted laparoscopy, Dissection, Kidney neoplasms
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