title: Direct upper kidney pole access and early ligation of renal pedicle significantly facilitates transperitoneal laparoscopic nephrectomy procedures: Tunc technique.
abstract: We modified our technique in transperitoneal laparoscopic nephrectomies and compared its results with the classical technique. Classical technique was performed in 85 cases (group 1). Modified technique (n=98) included direct kidney upper pole access and early ligation of renal pedicle (group 2). No significant differences were detected regarding mean patient age, intraoperative blood loss, and duration of hospital stay between the 2 groups (P>0.05). Mean operation time was 64.9 ± 19.3 and 28.2 ± 7.7 minutes, respectively in groups 1 and 2 (P=0.001). Mean operation time including right nephrectomies was 68.7 ± 23.4 and 24.2 ± 6.3 minutes, respectively in groups 1 and 2 (P=0.001). Mean operation time including left nephrectomies was 63.8 ± 17.1 and 33.6 ± 5.1 minutes, respectively in groups 1 and 2 (P=0.001). Similarly, mean operation time was significantly shorter in group 2 when analysis was performed among right and left radical and simple nephrectomies between the 2 groups (P=0.001). Direct upper kidney pole access and early ligation of renal pedicle seems to be significantly facilitating transperitoneal laparoscopic nephrectomy procedures.
authors.affiliation: Department of Urology, Gazi University School of Medicine, Ankara, Turkey. lutfitunc@gmail.com
authors.forename: Lutfi
authors.initials: L
authors.lastname: Tunc
authors.forename: Abdullah Erdem
authors.initials: AE
authors.lastname: Canda
authors.forename: Fazli
authors.initials: F
authors.lastname: Polat
authors.forename: Metin
authors.initials: M
authors.lastname: Onaran
authors.forename: Sinan
authors.initials: S
authors.lastname: Atkin
authors.forename: Hasan
authors.initials: H
authors.lastname: Biri
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Bozkirli
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008026:Ligation; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012082:Renal Veins / Q000293:injuries; D013525:Surgical Instruments; D017792:Surgical Stapling