title: Hand-assisted laparoscopic renal surgery: hand-port incision complications.
abstract: OBJECTIVE
  Hand-assisted laparoscopic (HAL) renal surgery is an accepted standard of practice. We report our complications at the hand port-site incision in various HAL urologic procedures.
  
  
  METHODS
  Data and follow-up were complete for 54 patients who underwent HAL nephrectomy. HAL partial nephrectomy, or HAL nephroureterectomy at our institution from October 2001 to April 2003. A retrospective review of the patients' charts was performed to identify the incidence of postoperative hand port-site complications. The mean patient age was 59 years, and the mean follow-up was 5.4 months.
  
  
  RESULTS
  Five complications were observed in four patients (9.3%). One patient had a superficial wound infection (1.9%) and an incisional hernia (1.9%) that was surgically repaired. One patient had a superficial incisional breakdown that healed well after conservative measures. One obese patient with severe chronic obstructive pulmonary disease eviscerated through his hand-port incision after a coughing spell. This was repaired operatively, and the patient healed well with the aid of an abdominal binder. One patient developed an enterocutaneous fistula at her hand-port site that healed well after both operative and conservative management.
  
  
  CONCLUSIONS
  The technique of HAL renal surgery is safe and effective. Complications associated with the hand-port incision exist, and as they become better defined, the surgeon may take extra steps toward their recognition and prevention.
authors.affiliation: Department of Surgery, Division of Urology, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Terranova
authors.forename: Khurram M
authors.initials: KM
authors.lastname: Siddiqui
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Preminger
authors.forename: David M
authors.initials: DM
authors.lastname: Albala
mesh_terms: D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications