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• W2015492778 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jul 2003Laparoscopic Ice Slush Renal Hypothermia for Partial Nephrectomy: The Initial Experience INDERBIR S. GILL, SIDNEY C. ABREU, MIHIR M. DESAI, ANDREW P. STEINBERG, ANUP P. RAMANI, CHRISTOPHER NG, KEVIN BANKS, ANDREW C. NOVICK, and JIHAD H. KAOUK INDERBIR S. GILLINDERBIR S. GILL More articles by this author , SIDNEY C. ABREUSIDNEY C. ABREU More articles by this author , MIHIR M. DESAIMIHIR M. DESAI More articles by this author , ANDREW P. STEINBERGANDREW P. STEINBERG More articles by this author , ANUP P. RAMANIANUP P. RAMANI More articles by this author , CHRISTOPHER NGCHRISTOPHER NG More articles by this author , KEVIN BANKSKEVIN BANKS More articles by this author , ANDREW C. NOVICKANDREW C. NOVICK More articles by this author , and JIHAD H. KAOUKJIHAD H. KAOUK More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000072332.02529.10AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We describe a novel technique of laparoscopic renal hypothermia with intracorporeal ice slush during partial nephrectomy as well as clinical experience with the initial 12 patients. Materials and Methods: A total of 12 select patients with an infiltrating renal tumor who were candidates for nephron sparing surgery underwent transperitoneal laparoscopic partial nephrectomy with renal hypothermia. An Endocatch II (United States Surgical Corp., Norwalk, Connecticut) bag was placed around the mobilized kidney and its drawstring was cinched around the intact renal hilum. The renal artery and vein were occluded en bloc with a Satinsky clamp. The bottom of the engaged bag was retrieved through a 12 mm port site and opened, and ice slush was introduced within the bag to completely surround the kidney. After renal hypothermia was achieved laparoscopic partial nephrectomy was performed by duplicating open surgical techniques. Renal parenchymal temperature was measured using a thermocouple needle in 5 patients. Median tumor size was 3.2 cm (range 1.5 to 5.5), 6 tumors (50%) were central in location and an imperative indication for partial nephrectomy was present in 7 patients (58%). Results: All procedures were successfully completed laparoscopically without open conversion. Median time to deploy the bag around the kidney was 7 minutes (range 5 to 20), the median volume of ice slush introduced was 600 cc (range 300 to 750) and the time needed to insert the ice slush was 4 minutes (range 3 to 10). Median blood loss was 200 cc, total ischemia time was 43.5 minutes (range 25 to 55) and total operative time was 4.3 hours (range 3 to 5.5). Nadir renal parenchymal temperature was 5C to 19C and the mean decrease in systemic temperature was 0.6C. Histopathology confirmed renal cell carcinoma in 11 patients (92%), of whom all had negative surgical margins. Intraoperative complications occurred in 2 initial patients, including partial bag slippage in 1 and Satinsky clamp malfunction in 1. Postoperatively renal scan confirmed a functioning ipsilateral kidney in all cases. Conclusions: To our knowledge we present the initial clinical report of laparoscopic renal hypothermia for partial nephrectomy. By replicating standard open surgical practice our intracorporeal ice slush technique has the potential to extend the scope of laparoscopic partial nephrectomy to more complicated renal tumors. 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(2018) Reply by AuthorsJournal of Urology, VOL. 180, NO. 6, (2369-2369), Online publication date: 1-Dec-2008.Orvieto M, Zorn K, Lyon M, Tohurst S, Rapp D, Mikhail A, Oras J, Son H, Kasza K, Brendler C and Shalhav A (2018) Laparoscopic Ice Slurry Coolant for Renal HypothermiaJournal of Urology, VOL. 177, NO. 1, (382-385), Online publication date: 1-Jan-2007.Gill I, Colombo J, Moinzadeh A, Finelli A, Ukimura O, Tucker K, Kaouk J and Desai M (2018) Laparoscopic Partial Nephrectomy in Solitary KidneyJournal of Urology, VOL. 175, NO. 2, (454-458), Online publication date: 1-Feb-2006.Yossepowitch O, Eggener S, Serio A, Huang W, Snyder M, Vickers A and Russo P (2018) Temporary Renal Ischemia During Nephron Sparing Surgery is Associated With Short-Term but Not Long-Term Impairment in Renal FunctionJournal of Urology, VOL. 176, NO. 4, (1339-1343), Online publication date: 1-Oct-2006.NG C, GILL I, RAMANI A, STEINBERG A, SPALIVIERO M, ABREU S, KAOUK J and DESAI M (2018) TRANSPERITONEAL VERSUS RETROPERITONEAL LAPAROSCOPIC PARTIAL NEPHRECTOMY: PATIENT SELECTION AND PERIOPERATIVE OUTCOMESJournal of Urology, VOL. 174, NO. 3, (846-849), Online publication date: 1-Sep-2005.LAVEN B, ORVIETO M, CHUANG M, RITCH C, MURRAY P, HARLAND R, INMAN S, BRENDLER C and SHALHAV A (2018) RENAL TOLERANCE TO PROLONGED WARM ISCHEMIA TIME IN A LAPAROSCOPIC VERSUS OPEN SURGERY PORCINE MODELJournal of Urology, VOL. 172, NO. 6 Part 1, (2471-2474), Online publication date: 1-Dec-2004.BHAYANI S, RHA K, PINTO P, ONG A, ALLAF M, TROCK B, JARRETT T and KAVOUSSI L (2018) LAPAROSCOPIC PARTIAL NEPHRECTOMY: EFFECT OF WARM ISCHEMIA ON SERUM CREATININEJournal of Urology, VOL. 172, NO. 4 Part 1, (1264-1266), Online publication date: 1-Oct-2004.HERRELL S (2018) LAPAROSCOPIC PARTIAL NEPHRECTOMY TECHNIQUES: DEVELOPMENTS AND TRANSLATIONJournal of Urology, VOL. 172, NO. 6 Part 2, (2553-2556), Online publication date: 1-Dec-2004. Volume 170Issue 1July 2003Page: 52-56 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.KeywordsnephrectomykidneyhypothermialaparoscopyMetricsAuthor Information INDERBIR S. GILL More articles by this author SIDNEY C. ABREU More articles by this author MIHIR M. DESAI More articles by this author ANDREW P. STEINBERG More articles by this author ANUP P. RAMANI More articles by this author CHRISTOPHER NG More articles by this author KEVIN BANKS More articles by this author ANDREW C. NOVICK More articles by this author JIHAD H. KAOUK More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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