Téma: 

hand assisted laparoscopic partial nephrectomy with the radiofrequency coagulation

Jaroslav Všetička1, Richard Fiala2

Aim: To evaluate feasibility of hand assisted laparoscopic partial nephrectomy combined with the radiofrequency coagulationassisted technique. Patients and methods: In all, 55 patients with solitary renal tumors smaller than 53 mm underwent hand assisted partial nephrectomy. Kidney and renal hilum were dissected. Healthy tissue encompassing renal masses was coagulated using four tined needle probe attached to radiofrequency generator. The probe tines were deployed to create ablation zone 1 cm wide. Tumor was removed using cold scissors cutting in coagulated area. Results: Mean patient age was 64.8 years (range 45-80). Mean tumor size was 35.5 mm (10-53). 18 (32.7 %) masses were located at poles, and 37 (67.3 %) centrally. Sixteen tumors were exophytic and remaining 9 intraparenchymal. Tumor was in contact with collecting system in 15 (27.3 %) patients. Mean operative time for coagulation with radiofrequency probe was 13 minutes (5-25) and mean operative time for whole partial nephrectomy was 88 minutes (35-220). Intraoperative complications were in one case (1.8 %) and minor postoperative in two cases (3.6 %). All tumor margins were negative. Conclusion: Early experience with hand assisted and radiofrequency assisted laparoscopic partial nephrectomy shows that it is safe and quick method enabling excellent control of bleeding and thus facilitating and speeding up operation and allowing standard pathologic examination of removed tissue.

Ročník 2009  Témy časopisu Clinical urology 2 / 2009

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