Hand-assisted laparoscopic partial nephrectomy by using an "open" device of microwave tissue coagulator.
OBJECTIVE
In this article, we report our experience in using an "open" device of a microwave tissue coagulator (MTC), for the hand-assisted laparoscopic partial nephrectomy (HALPN), as a safer, more reproducible method.


METHODS
From July 2005, 5 patients with small, exophytic renal tumors underwent an HALPN. In this procedure, the surgeon used a surgical handpiece MTC, which was originally designed for an open surgical procedure, and introduced it into the abdominal cavity through the GelPort. (Applied Medical, Rancho Santa Margarita, CA). The direction and angle of the needle puncture was easily and precisely changed in a timely fashion, depending on the site of coagulation. After coagulation, the tumor was resected with laparoscopic scissors and blunt dissection without renal pedicle clamping.


RESULTS
HALPN was successfully performed in all cases without any open conversions. Estimated blood loss was <100 mL in all cases. There was no postoperative complication, such as urine leakage or loss of renal function.


CONCLUSIONS
We believe that this technique minimizes the risk of unexpected collateral thermal damage by appropriate needle puncture and can be performed easily by urologists. The small incision does not greatly diminish the benefit of minimally invasive surgery.
Nozaki
Tetsuo
T
Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan. nozaki0921@yahoo.co.jp
Morii
Akihiro
A
Yasuda
Kenji
K
Watanabe
Akihiko
A
Komiya
Akira
A
Fuse
Hideki
H
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation*