Clinical application of laparoscopy-assisted small incision surgery in treatment of urological diseases / 第二军医大学学报

ABSTRACT

Objective To apply laparoscopy-assisted small incision surgery in complicated urological operation, and to summarize our experience. Methods We retrospectively analyzed the clinical data of 9 patients with renal tumors (3 with solitary kidney tumors, 2 with unilateral multiple tumors, 1 with bilateral tumors, and 3 with contralateral renal insufficiency), 3 patients with renal pelvic ureteropelvic junction obstruction (UPJO) and multiple stones, and 1 patient with distal ureteral tumor. All patients underwent laparoscopy-assisted small incision surgery in our department from Aug. 2007 to Jun. 2011. The key steps of the surgery were discussed and the clinical experience was summarized. Results (1) For 9 patients with renal tumors, the incision was 4-6 cm in length, the cold ischemia timewas (15 ±4) min, and the operation time ranged from 90 to 180 min. Drainage tubes were removed within 48 h after operation. No patient had bleeding, urinary fistula or other serious complications. (2) For the 3 patients with UPJO, the incision was 4-5 cm in length and the operation time was 110 to 190 min. Drainage tubes were removed within 3-5 d after operation. No patient had bleeding, urinary fistula or other serious complications. No patient had fever or back pain after removal of double-J stents. Intravenous pyelography showed no hydronephrosis and the renal structure was normal. (3) For the patient with ureteral tumor, the drainage tube was removed 3 d after operation and there was no complication. No patients in the present study used analgesic pump or analgesic medications after surgery. Conclusion Laparoscopy-assisted small incision surgery can reduce the length of incision, minimize injury, and protect renal function. Besides, the method is safe and capable of handling complicated situations, especially suitable for patients who are difficult to receive total laparoscopic surgery.