Troxel Scott A, Ross G, Teague J L
Division of Urology, University of Missouri, Columbia, Missouri 65212, USA.
J Endourol. 2005 Sep;19(7):785-7. doi: 10.1089/end.2005.19.785.
To describe a laparoscopic hand-assisted approach to renal autotransplantation that allows both harvest and transplant through the same incision.
Three patients underwent renal autotransplantation from May 2003 to April 2004, two for loin pain-hematuria syndrome and one for severe ureteral-stricture disease. Two patients underwent autotransplantation on the left and one on the right. Hand-assisted laparoscopy was planned such that inferomedial extension of the hand-port incision would provide adequate exposure of the iliac vessels for autotransplantation.
The average operative time was 240 minutes, the warm ischemia time was 2 minutes 43 seconds, and the hospital stay was 3 days. All three patients had successful graft function by postoperative renal scan with a mean follow-up of 7.1 months.
Hand-assisted laparoscopic renal harvest for autotransplantation can be completed with placement of the hand port such that transplantation can be accomplished through the same incision. As many of these patients have had multiple prior retroperitoneal operations, the intracorporeal hand can greatly facilitate these potentially difficult dissections with no added morbidity.
描述一种腹腔镜手辅助肾自体移植方法，该方法可通过同一切口完成肾脏获取及移植。
2003年5月至2004年4月，3例患者接受了肾自体移植，其中2例因腰腹痛-血尿综合征，1例因严重输尿管狭窄疾病。2例患者在左侧进行自体移植，1例在右侧。计划采用手辅助腹腔镜手术，使手孔切口向内侧下延伸，以便为自体移植充分暴露髂血管。
平均手术时间为240分钟，热缺血时间为2分43秒，住院时间为3天。术后肾脏扫描显示，所有3例患者移植肾功能均成功，平均随访7.1个月。
通过放置手孔，可完成手辅助腹腔镜下肾自体移植的肾脏获取，从而能通过同一切口完成移植。由于许多此类患者既往曾接受多次腹膜后手术，体内手能极大地便利这些潜在的困难解剖操作，且不增加发病率。
