title: Laparoscopic partial nephrectomy: hand-assisted technique.
abstract: Laparoscopic partial nephrectomy (LPN) is a challenging procedure that has become more popular as techniques have evolved and made the procedure more standardized. We present our hand-assisted technique for LPN. In order to meet the challenges of larger, deeper lesions and to address complications, our technique has evolved from pure hand assistance to hand assistance with hilar clamping and hemostatic adjuncts. We discuss patient selection, preparation and access, renal exposure, preparation of hemostatic agents, resection of the mass, hemostasis, and closure. The results of 76 hand-assisted LPNs (HALPNs) are summarized. While our technique will undoubtedly continue to evolve, HALPN appears to be safe and effective for minimally invasive nephron-sparing surgery.
authors.affiliation: Division of Urology, University of Kentucky, Lexington, Kentucky 40536, USA. Stephen.Strup@uky.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Strup
authors.forename: Jenne
authors.initials: J
authors.lastname: Garrett
authors.forename: Leonard
authors.initials: L
authors.lastname: Gomella
authors.forename: Randall
authors.initials: R
authors.lastname: Rowland
mesh_terms: D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D006225:Hand; D006488:Hemostasis, Surgical / Q000379:methods; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D018579:Patient Selection
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics