Korean J Urol.  2007 Jan;48(1):6-11. 10.4111/kju.2007.48.1.6.

The Early Experience of Hand Assisted Laparoscopic Surgery in Nephroureterectomy

• Choi MH
• Chung H

• KMID: 1915013
• DOI: http://doi.org/10.4111/kju.2007.48.1.6

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.

Keyword

Nephroureterectomy; Visual analogue pain scale

MeSH Terms

Hand*
Humans
Laparoscopy*
Pain Measurement
Surgical Procedures, Minimally Invasive
Urinary Bladder
Weights and Measures

Figure

• 

  Fig. 1 Port sites of a HALS nephroureterectomy. A: first trocar, B: second trocar, H: hand port, HALS: hand assisted laparoscopic surgery, AAL: anterior axillary line, MAL: mid axillary line.

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