+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Hand-assisted laparoscopic nephrectomy: technical considerations

Hand-assisted laparoscopic nephrectomy: technical considerations

Techniques in Urology 3(3): 123-128

Laparoscopic nephrectomy can be technically difficult and associated with lengthy operative times because of the limitations imposed by working with long instruments rotating about a fixed site on the abdominal wall, and without direct manual contact with the tissue. Hand-assisted laparoscopy is an option that addresses these problems. Herein we report our initial technique for hand-assisted laparoscopic nephrectomy. After obtaining pneumoperitoneum and placing a 12-mm cannula lateral to the rectus muscle, a 7- to 8-cm incision is made in the upper midline. A commercially available wound protector and occlusive sleeve are inserted. Once an arm strap has been secured, the surgeon can operate with one hand in the abdomen while maintaining pneumoperitoneum. Using instruments placed through one or two additional laparoscopic ports, the nephrectomy is completed and the specimen is removed through the upper midline incision. Our continued experience with 10 hand-assisted laparoscopic nephrectomies to date has been favorable. Hand-assisted laparoscopic nephrectomy may facilitate the laparoscopic management of demanding pathologies, such as severely inflamed kidneys and larger tumors. It is particularly advantageous when intact specimens are required. Although more experience is required to define the role of hand-assisted urologic laparoscopy, we are encouraged by our initial technique and results.

(PDF emailed within 1 workday: $29.90)

Accession: 046211054

Download citation: RISBibTeXText

PMID: 9422442

Related references

Technical considerations in hand-assisted laparoscopic live donor nephrectomy: initial Taiwan experience from National Taiwan University Hospital. Journal of the Formosan Medical Association 101(1): 76-79, 2002

Comparative outcomes of open nephrectomy, hand-assisted laparoscopic nephrectomy, and full laparoscopic nephrectomy for living donors. Transplantation Proceedings 44(1): 22-25, 2012

Hand-assisted laparoscopic surgery (HALS) for live donor nephrectomy is more time- and cost-effective than standard laparoscopic nephrectomy. Surgical Endoscopy 16(3): 422-425, 2002

Comparison of robot-assisted nephrectomy with laparoscopic and hand-assisted laparoscopic nephrectomy. Jsls 14(3): 374-380, 2011

Case report: technical and functional implications of hand-assisted laparoscopic partial nephrectomy in a patient with autosomal dominant polycystic kidney disease. Journal of Endourology 21(6): 625-627, 2007

Comparison of Hand-Assisted Laparoscopic vs Robot-Assisted Laparoscopic vs Open Partial Nephrectomy in Patients with T1 Renal Masses. Journal of Endourology 31(4): 374-379, 2014

Hand-assisted laparoscopic versus robot-assisted laparoscopic partial nephrectomy: comparison of short-term outcomes and cost. Journal of Endourology 27(2): 182-188, 2013

Hand assisted laparoscopic nephrectomy: Comparison to standard laparoscopic nephrectomy. Journal of Urology 160(1): 22-27, 1998

Cost analysis of robot-assisted laparoscopic versus hand-assisted laparoscopic partial nephrectomy. Journal of Endourology 26(8): 1030-1037, 2012

Hybrid technique using a Satinsky clamp for right-sided transperitoneal hand-assisted laparoscopic donor nephrectomy: comparison with left-sided standard hand-assisted laparoscopic technique. Urology 84(6): 1529-1534, 2015

Hand-assisted laparoscopic donor nephrectomy versus standard laparoscopic donor nephrectomy: a comparison study in the canine model. Techniques in Urology 5(3): 174-178, 1999

Hand-assisted retroperitoneoscopic living donor nephrectomy superior to laparoscopic nephrectomy. Transplantation Proceedings 35(2): 782-783, 2003

Morbidity of hand-assisted laparoscopic nephrectomy according with indication of nephrectomy. Malignant vs. benign. 2007

Hand assisted laparoscopic nephrectomy vs open nephrectomy Single oncologic surgeon experience. Journal of Endourology 15(Supplement 1): A46, 2001

Comparison of recovery between open live donor nephrectomy and hand-assisted laparoscopic nephrectomy. Journal of Urology 159(5 SUPPL ): 116, 1998