title: Hand-assisted retroperitoneoscopic radical nephrectomy: initial experience.
abstract: 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.
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. kawauchi@koto.kpu-m.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.forename: Akira
authors.initials: A
authors.lastname: Fujito
authors.forename: Osamu
authors.initials: O
authors.lastname: Ukimura
authors.forename: Jintetsu
authors.initials: J
authors.lastname: Soh
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Imaide
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
mesh_terms: 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