Abstract:
PURPOSE:To assess the safety and efficacy of conversion from pure laparoscopy to hand-assisted laparoscopy to control mild-to-moderate bleeding during renal surgery. PATIENTS AND METHODS:Between August 2006 and August 2008, we performed 94 laparoscopic nephrectomies (44 partial and 50 radical). A total of three radical nephrectomies were converted from pure to hand-assisted laparoscopy for control of bleeding. The first patient was a 44-year-old man with a 14-cm cystic renal mass. The second patient was a 52-year-old man with a 3.8-cm renal mass, and the third patient was an 86-year-old woman with a 7-cm renal mass. RESULTS:In all three procedures, the indication for conversion was bleeding from the renal hilum or the kidney parenchyma during dissection. The bleeding was difficult to control using pure laparoscopy, and therefore a hand port was inserted. Time for conversion and placement of the hand port averaged less than 7 minutes. Total estimated blood loss for the three patients was 800 mL, 2000 mL, and 650 mL, respectively. One patient needed a transfusion with three units of packed red blood cells. The postoperative course was uneventful in all patients, except for one patient who had prolonged ileus and stayed in the hospital for 6 days. The remaining two patients were discharged on postoperative days 2 and 3. CONCLUSIONS:Conversion from pure to hand-assisted laparoscopy for bleeding control is feasible and effective. It adds minimal morbidity while maximizing cosmesis, and it should be considered as an alternative to open conversion in cases of mild-to-moderate bleeding.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Vricella GJ,Young DB,Boncher NA,Madi Rdoi
10.1089/end.2010.0321subject
Has Abstractpub_date
2011-01-01 00:00:00pages
81-4issue
1eissn
0892-7790issn
1557-900Xjournal_volume
25pub_type
杂志文章abstract::Although most caliceal diverticula are asymptomatic, they can be associated with pain, and concomitant calculi are common. When treatment is indicated, a variety of surgical options are available, although the management is often a challenge even to the most experienced surgeon. We review the indications, surgical opt...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
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