title: Laparoscopic partial nephrectomy: initial experience and comparison to the open surgical approach.
abstract: During an 18-month period, 6 laparoscopic partial nephrectomies were attempted, 4 of which were successful. The surgical technique was modified and improved between cases aided by new laparoscopic instrumentation, such as the argon beam coagulator and the 7.5 MHz. ultrasonic sector scanning system. In a retrospective comparison between laparoscopic and open partial nephrectomy, estimated blood loss was 525 ml. for the former versus 708 ml. for the latter procedure. However, operating time was more than 2 hours longer with the laparoscopic approach. The major advantages of the laparoscopic procedure appear to be a more rapid return to full diet, less postoperative pain and less requirement for parenteral narcotics. Despite the small size of this series and limited followup data, convalescence may be shortened by 4 weeks after laparoscopic partial nephrectomy. Patients with benign diseases of the kidney, especially with a duplicated collecting system, who require partial nephrectomy may be considered candidates for the laparoscopic approach. The advantages to the patient, however, may be offset by the technical demands on the surgeon.
authors.affiliation: Department of Urology, University of Iowa College of Medicine, Iowa City, USA.
authors.forename: H N
authors.initials: HN
authors.lastname: Winfield
authors.forename: J F
authors.initials: JF
authors.lastname: Donovan
authors.forename: G O
authors.initials: GO
authors.lastname: Lund
authors.forename: K J
authors.initials: KJ
authors.lastname: Kreder
authors.forename: K E
authors.initials: KE
authors.lastname: Stanley
authors.forename: B P
authors.initials: BP
authors.lastname: Brown
authors.forename: S A
authors.initials: SA
authors.lastname: Loening
authors.forename: R V
authors.initials: RV
authors.lastname: Clayman
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001810:Blood Volume; D003289:Convalescence; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D020706:Laparoscopes; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors