Laparoscopic partial nephrectomy using a microwave tissue coagulator for treating small peripheral renal tumors.
BACKGROUND
Laparoscopic partial nephrectomy has been recently applied as a minimally invasive procedure. Several non-ischemic operation devices in partial nephrectomy have been developed. However, the problem related to maintenance of renal homeostasis remains. We investigated the efficacy and safety of a microwave tissue coagulator in laparoscopic partial nephrectomy.


METHODS
Between April 2001 and February 2003, eleven patients with small renal tumors underwent laparoscopic partial nephrectomy using a microwave tissue coagulator. Seven patients underwent hand-assisted laparoscopic procedure and 4 pure laparoscopic procedure.


RESULTS
The mean tumor size on preoperative CT scan was 2.5 cm (range: 2.0 to 4.0 cm), the mean operative time was 307 minutes (range: 160 to 580 minutes), and the mean estimated blood loss was 154.4 ml (range: 50 to 1,140 ml). The microwave tissue coagulator well controlled the renal bleeding and maintained renal function. All patients safely underwent partial nephrectomy without inducing renal ischemia. A complication of urine leakage was recognized in only one patient with hypoproteinemia caused by nephrotic syndrome.


CONCLUSIONS
Laparoscopic partial nephrectomy using a microwave tissue coagulator was a useful method for achieving homeostasis, and was less invasive for treating small renal tumors.
Hamasaki
Tsutomu
T
Department of Urology, Nippon Medical School, Tokyo 113-8602, Japan. hamasaki@nms.ac.jp
Kondo
Yukihiro
Y
Matuzawa
Ichiro
I
Tsuboi
Narumi
N
Nishimura
Taiji
T
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*