Hand-assisted retroperitoneoscopic radical nephrectomy: initial experience.
OBJECTIVE
To report our initial experience of hand-assisted retroperitoneoscopic radical nephrectomy for stage T1 renal tumors.


METHODS
The clinical data on 22 consecutive patients who had undergone hand-assisted retroperitoneoscopic radical nephrectomy and 22 who had undergone open radical nephrectomy were reviewed. The operation was performed with a hand placed retroperitoneally through a pararectal longitudal 7-7.5 cm incision using a LAP DISC.


RESULTS
The total operating time was between 2.3 and 5.8 h (mean: 3.4 h). The estimated blood loss was between 15 and 650 mL (mean: 170 mL). The complication rate was 9% (2/22). No conversions to open procedure occurred. In comparison to open radical nephrectomy, the operating time was similar (3.4 vs 3.9 h) whereas the estimated blood loss was significantly less in this procedure (170 vs 495 mL). During the convalescence period the patients revealed significantly less postoperative pain, shorter intervals to resuming oral intake and more rapid return to normal activities compared to the open radical nephrectomy patients.


CONCLUSIONS
Hand-assisted retroperitoneoscopic radical nephrectomy is an effective and safe procedure for T1 renal tumors.
Kawauchi
Akihiro
A
Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. kawauchi@koto.kpu-m.ac.jp
Fujito
Akira
A
Ukimura
Osamu
O
Soh
Jintetsu
J
Mizutani
Yoichi
Y
Imaide
Yoichiro
Y
Miki
Tsuneharu
T
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space