Comparison of a novel endoscope holder and traditional camera assistant for laparoscopic simple nephrectomy in a porcine model.
OBJECTIVE
To establish the feasibility of single-surgeon laparoscopy with application of a novel endoscope-holder device and to compare this technique with traditional assistant-driven laparoscopic camera control.


METHODS
Bilateral simple nephrectomies were performed in six pigs. On one side, the operating surgeon employed the "scope holder" and performed the surgery without a laparoscopic assistant. On the contralateral side, an experienced camera operator was responsible for control of the laparoscopic field of vision in the traditional manner. The time required for hilar ligation and complete renal mobilization was documented. Pigs were sacrificed immediately after the procedure.


RESULTS
The mean operative times for scope-holder and camera person-assisted nephrectomy were 20.7 minutes and 19.3 minutes, respectively. The time to hilar ligation in the scope-holder and camera-operator-assisted cohorts was 13 and 14.5 minutes, respectively. There were no significant differences in operative times or blood loss in the two groups. The operative surgeon perceived some increase in shoulder and neck pain with use of the scope holder.


CONCLUSIONS
This novel device provides a means for the operative surgeon to safely perform a laparoscopic nephrectomy alone without significantly increasing operative time or morbidity.
Quayle
Sejal S
SS
Department of Urology, Washington University School of Medicine, Saint Louis, Missouri, USA.
Collyer
W
W
Vanlangendonck
R
R
Landman
Jaime
J
D000818:Animals; D019723:Endoscopes; D005240:Feasibility Studies; D010535:Laparoscopy / Q000379:methods*; D023421:Models, Animal; D018763:Muscle Fatigue; D009392:Nephrectomy / Q000295:instrumentation*; D013552:Swine; D020535:Video-Assisted Surgery