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• W2125418533 abstract "No AccessJournal of UrologyAdult Urology1 Mar 2011Outcome of Hand Assisted Laparoscopic Bilateral Native Nephrectomy in Transplant Recipients Rizk El-Galley, Seena Safavy, J. Erik Busby, and Jan Colli Rizk El-GalleyRizk El-Galley More articles by this author , Seena SafavySeena Safavy More articles by this author , J. Erik BusbyJ. Erik Busby More articles by this author , and Jan ColliJan Colli More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.10.084AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We explored the safety and reproducibility of hand assisted laparoscopic bilateral native nephrectomy. We also present our improvements to the surgical technique. Materials and Methods: We retrospectively reviewed the charts of 36 patients who underwent hand assisted laparoscopic bilateral nephrectomy at our institution between 2003 and 2010. In all cases the 2 kidneys were removed transperitoneally via a hand assisted laparoscopic technique. Results: Mean operative time was 222 minutes. Pathological kidney size was 20 to 34 cm. Mean hospital stay was 3 days (range 1 to 13). Average estimated blood loss was 175 cc (range 50 to 200). No patient required intraoperative blood transfusion. There were no intraoperative complications and no conversions to open surgery. Postoperatively complications developed in 8 patients (22%), including temporary adrenal insufficiency and pulmonary embolism in 1 each, and myocardial infarction, superficial wound infection and loss of arteriovenous fistula function in 2 each. According to the Clavien-Dindo classification complications were grades 1, 2, 3 and 4a in 2, 3, 1 and 2 patients, respectively. A total of 18 patients with kidney transplants continued to have normal graft function after surgery. Conclusions: Simultaneous hand assisted bilateral nephrectomies are safe and reproducible. The complication rate is low and postoperative hospital stay is short compared to those in published open surgery series. Graft function was preserved in patients who underwent renal transplantation before native kidney removal. References 1 : Bilateral nephrectomy in patients with polycystic kidney disease. Surg Gynecol Obstet1973; 137: 819. Google Scholar 2 : Management of end-stage autosomal dominant polycystic kidney disease with hemodialysis and transplantation. Clin Nephrol1988; 30: 315. Google Scholar 3 : Laparoscopic nephrectomy: initial case report. J Urol1991; 146: 278. Link, Google Scholar 4 : Laparoscopic bilateral nephrectomy: Results in 11 renal transplant patients. J Urol1997; 157: 445. Link, Google Scholar 5 : Bilateral hand-assisted laparoscopic nephrectomy for autosomal dominant polycystic kidney disease using a single midline HandPort incision. Urology2002; 59: 32. Google Scholar 6 : Pretransplant bilateral hand-assisted laparoscopic nephrectomy in adult patients with polycystic kidney disease. JSLS2005; 9: 262. Google Scholar 7 : A novel approach to bilateral hand assisted laparoscopic nephrectomy for autosomal dominant polycystic kidney disease. Surg Endosc2006; 20: 679. Google Scholar 8 : Laparoscopic bilateral hand assisted nephrectomy for autosomal dominant polycystic kidney disease: initial experience. J Urol2001; 166: 42. Link, Google Scholar 9 : Bilateral laparoscopic nephrectomy for significantly enlarged polycystic kidneys: a technique to optimize outcome in the largest of specimens. BJU Int2008; 101: 1019. Google Scholar 10 : Laparoscopic nephrectomy in patients with end-stage renal disease and autosomal dominant polycystic kidney disease. Am J Kidney Dis2000; 35: 720. Google Scholar 11 : Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg2004; 240: 205. Google Scholar 12 : Hand-assisted laparoscopic nephrectomy in autosomal dominant polycystic kidney disease. J Endourol2004; 18: 379. Google Scholar 13 : Bilateral laparoscopic radical nephrectomy for renal tumors in patients with acquired cystic kidney disease. J Laparoendosc Adv Surg Tech A2005; 15: 606. Google Scholar 14 : Limitations of laparoscopy for bilateral nephrectomy for autosomal dominant polycystic kidney disease. J Urol2007; 177: 627. Link, Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 3March 2011Page: 1021-1025 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordslaparoscopynephrectomysurgical procedures, minimally invasivekidney transplantationkidneyMetricsAuthor Information Rizk El-Galley More articles by this author Seena Safavy More articles by this author J. Erik Busby More articles by this author Jan Colli More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2125418533 title "Outcome of Hand Assisted Laparoscopic Bilateral Native Nephrectomy in Transplant Recipients" @default.
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