Retroperitoneoscopic nephrectomy (RN): using the gravity technique to facilitate specimen entrapment.
BACKGROUND
Kidney entrapment is generally considered to be a difficult step in retroperitoneoscopic nephrectomy (RN). Normally, a large device is needed to accommodate the specimen, which may measure </=14 x 10 cm. There is just too little space to maneuver either the entrapment device or the specimen. Herein we describe a technique that can overcome this difficulty and even turn the space limitation to advantage.


METHODS
After the nephrectomy, the specimen is pushed caudally. A 15-mm Endocatch is inserted via the posterior cranial port. It is positioned strategically underneath the specimen so that when the entrapment bag is released, the specimen will have no room to move (because of the limited space) and will simply fall into the bag (because of gravity).


RESULTS
We have used this technique for our last four cases of retroperitoneoscopic nephrectomy and found that it remarkably shortened the operative time for this step.


CONCLUSIONS
One of the criticisms leveled against retroperitoneoscopic surgery concerns the problems posed by the space limitation. This technique turns the space limitation into an advantage and guarantees successful specimen entrapment.
Li
S K
SK
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong, SAR, China.
Hou
S S
SS
Li
M K
MK
D006112:Gravitation; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D011187:Posture; D012187:Retroperitoneal Space