Hand-assisted laparoscopic partial nephrectomy by using an "open" device of microwave tissue coagulator.

PURPOSE

In this article, we report our experience in using an "open" device of a microwave tissue coagulator (MTC), for the hand-assisted laparoscopic partial nephrectomy (HALPN), as a safer, more reproducible method.

PATIENTS AND METHODS

From July 2005, 5 patients with small, exophytic renal tumors underwent an HALPN. In this procedure, the surgeon used a surgical handpiece MTC, which was originally designed for an open surgical procedure, and introduced it into the abdominal cavity through the GelPort. (Applied Medical, Rancho Santa Margarita, CA). The direction and angle of the needle puncture was easily and precisely changed in a timely fashion, depending on the site of coagulation. After coagulation, the tumor was resected with laparoscopic scissors and blunt dissection without renal pedicle clamping.

RESULTS

HALPN was successfully performed in all cases without any open conversions. Estimated blood loss was <100 mL in all cases. There was no postoperative complication, such as urine leakage or loss of renal function.

CONCLUSIONS

We believe that this technique minimizes the risk of unexpected collateral thermal damage by appropriate needle puncture and can be performed easily by urologists. The small incision does not greatly diminish the benefit of minimally invasive surgery.