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BMC Urology
Published in: BMC Urology 1/2013

Open Access 01-12-2013 | Research article

Laser-supported partial laparoscopic nephrectomy for renal cell carcinoma without ischaemia time

Authors: Hagen Loertzer, Arne Strauß, Rolf Herrmann Ringert, Philine Schneider

Published in: BMC Urology | Issue 1/2013

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Abstract

Background

To date, elective nephron-sparing surgery is an established method for the exstirpation of renal tumors. While open partial nephrectomy remains the reference standard of the management of renal masses, laparoscopic partial nephrectomy (LPN) continues to evolve. Conventional techniques include clamping the renal vessels risking ischaemic damage of the clamped organ. Thus, new techniques are needed that combine a sufficient tissue incision for exstirpation of the tumor with an efficient coagulation to assure haemostasis and abandon renal vessel clamping in LPN. Laser-excision of renal tumors during laparoscopic surgery seems to be a logical solution.

Methods

We performed nephron-sparing surgery without clamping of the renal vessels in 11 patients with a renal tumor in exophytic position (mean size 32 mm, ranging 8–45 mm) by laser-supported LPN.

Results

Regular ultrasound monitoring and insertion of a temporary drainage showed no evidence of postoperative hemorrhage. All tumors were removed with a histopathologically confirmed surrounding margin of normal renal tissue (R0 resection). Serum creatinine, hemoglobin, and hematocrit were nearly unaltered before and after surgery.

Conclusions

The experience won in these patients have confirmed that laser-assisted LPN without clamping of the renal vessels could be a safe and gentle alternative to classic partial nephrectomy in patients with exophytic position of renal tumors.
Appendix
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Metadata
Title
Laser-supported partial laparoscopic nephrectomy for renal cell carcinoma without ischaemia time
Authors
Hagen Loertzer
Arne Strauß
Rolf Herrmann Ringert
Philine Schneider
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2013
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/1471-2490-13-31

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