Hand-assisted laparoscopic nephrectomy and nephroureterectomy: our experience in Hospital Universiti Kebangsaan Malaysia.

Hand-assisted laparoscopic nephrectomy (HAL-N) and nephroureterectomy (HAL-NU) were introduced to bridge the gap between open and laparoscopic surgery. This newer technique has the benefits of both laparoscopic and open surgical approaches but has a shorter learning curve and decreased operative time compared to laparoscopic surgery. A review of our 2-year experience showed that for the seventeen cases of HAL-N that was performed, the mean operative time was 187.8 minutes while the mean length of hospital stay was 4.1 days. For the two HAL-NU cases, the mean operative time was 415 minutes while the mean length of hospital stay was 5.5 days. Only one complication occurred and it was an incisional hernia at the hand-port site. There was no recurrence for the carcinoma cases. Our experience shows that this technique is feasible and safe.

Renal autotransplantation after an latrogenic left ureteric injury.

We report a case of renal autotransplantation performed successfully for an iatrogenic ureteric injury with loss of 9 cm of ureteric length. The surgical options available for management of ureteric injuries are discussed, varying from a simple re-anastomosis to the more complex renal autotransplantation.

Metastatic penile cancer presenting as hypercalcemia and pathological fracture of the humerus: a rare event.

Distant haematogenous metastasis in penile cancer is rare. A patient who had total penectomy and bilateral inguinal lymphadenectomy for penile cancer but later presented with hypercalcemia of malignancy and pathological fracture of the humerus is reported.