Laparoscopic partial nephrectomy techniques: developments and translation.
OBJECTIVE
Laparoscopic partial nephrectomy has recently emerged as a potential surgical option for select renal masses. Several new techniques and devices that may aid in laparoscopic partial nephrectomy are reviewed.


METHODS
I review several techniques studied and/or developed in our laboratory. Each technique was evaluated for effectiveness in the porcine model and is in translation to clinical practice.


RESULTS
Three techniques are reviewed. A hand assisted approach incorporating renal hilar clamping with hypothermia has proven successful for complex and multifocal lesions. Recent clinical studies, and our laboratory and clinical experience have shown a saline cooled monopolar dissector to be a valuable adjunct. A new and simple technique of achieving rapid hypothermia using a pure laparoscopic approach is described.


CONCLUSIONS
Laparoscopic partial nephrectomy continues to develop as a standard of care for select renal masses. New devices and techniques will continue to make the procedure safer and reproducible.
Herrell
S Duke
SD
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
D000818:Animals; D006488:Hemostasis, Surgical; D006801:Humans; D007036:Hypothermia, Induced; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*