[Prospective study of iliac extraction of the kidney after laparoscopic nephrectomy].
BACKGROUND
Various routes are used to extract the operative specimen during laparoscopic nephrectomy. The main points are compliance with rules of cancer surgery, when applicable, and minimum wall destruction. The objective of this study was to prospectively evaluate the low iliac approach.


METHODS
Prospective follow-up of 23 laparoscopic nephrectomies (17 tumours and 6 living donor kidney harvestings) in which the kidney was extracted via a low iliac incision measuring 5 to 7 cm.


RESULTS
The mean operating time was 188 +/- 50 min with a mean blood loss of 112 +/- 126 ml. The mean duration of the incision was 10 minutes. In the case of a tumour the mean weight of the operative specimen was 571 +/- 127 g in and the mean diameter of the mass was 5.7 +/- 1.9 cm. All grafted kidneys functioned normally. No surgical conversion was necessary. The mean follow-up was 9.6 +/- 1.2 months. No late postoperative complications were observed.


CONCLUSIONS
Radical nephrectomy or living donor kidney harvesting can be performed via laparoscopy with extraction of the operative specimen via a low iliac incision. This incision ensures extraction of very large specimens while preserving the aesthetic and functional advantages of laparoscopy with no increased cancer risk. They are simple to perform and easily reproducible via a transperitoneal or retroperitoneal approach. Absence of muscle section maintains the integrity of the abdominal wall. No postoperative incisional hernia has been observed.
Mallet
Richard
R
Service d'Urologie, Andrologie et de Transplantation renale, CHU Rangueil, Toulouse, France. mallet.r@chu-toulouse.fr
Vaessen
Christophe
C
Gamé
Xavier
X
Mouzin
Marc
M
Berrogain
Nathalie
N
Sarramon
Jean-Pierre
JP
Malavaud
Bernard
B
Rischmann
Pascal
P
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies