The Early Experience of Hand Assisted Laparoscopic Surgery in Nephroureterectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Recently, the growing interest in minimally invasive surgery and the development of instruments and accompanying techniques have allowed laparoscopic surgery to be performed in a wide range of urological fields. Herein, the procedures and results of 6 cases of hand assisted laparoscopic surgery (HALS) nephroureterectomy are reported. MATERIALS AND METHODS: The records of 6 and 5 patients, who had undergone either a laparoscopic HALS nephroureterectomy, with bladder cuff excision, or an open nephroureterectomy, with bladder cuff excision, were reviewed. RESULTS: The mean operation times were 194 (150-210) and 280 (250-310) minutes in HALS nephroureterectomy and open nephroureterectomy, respectively. The average pain scales recorded with HALS and classical open surgery were 1.5 (max. 2) and 7 (max. 8), respectively, on the second post operative day. CONCLUSIONS: HALS allows the operator to be notified with on-the-spot information and to have a feeling of complete control over the procedure, which helps to complete the operation in a shorter time, with the assistance of a tactile impression. Therefore, HALS can be concluded to be a better approach, which is a more acceptable procedure for the novice laparoscopic surgeon.