title: Simple nephrectomy: hand-assisted technique.
abstract: Chronic inflammation or prior surgical procedures may complicate the laparoscopic performance of simple nephrectomy. In these difficult cases, hand-assisted laparoscopy may be useful. The position of the hand port depends on the particular situation, but the port must allow flexion of the wrist and access to the entire surgical field. The hand-assisted procedure is similar to standard laparoscopy in analgesic use, time to oral intake, length of stay, and time to full recovery. Hand-assisted laparoscopy allows the inexperienced surgeon to perform laparoscopy with the aid of tactile sensation and three-dimensional spatial orientation. For the experienced surgeon, the technique offers an alternative to open conversion when the laparoscopic procedure fails to progress.
authors.affiliation: James Buchanan Brady Foundation, Department of Urology, The New York Presbyterian Hospital and Weill Medical College, Cornell University, New York, USA.
authors.forename: M
authors.initials: M
authors.lastname: Stifelman
authors.forename: A
authors.initials: A
authors.lastname: Andrade
authors.forename: R E
authors.initials: RE
authors.lastname: Sosa
authors.forename: S
authors.initials: S
authors.lastname: Shichman
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay / Q000191:economics; D009392:Nephrectomy / Q000191:economics / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D016896:Treatment Outcome