Nomura Takeo, Yamasaki Mutsushi, Takei Kohei, Sato Fuminori, Terachi Toshiro, Mimata Hiromitsu
Department of Urology, Oita University Faculty of Medicine, Yufu, Japan.
Asian J Endosc Surg. 2018 May;11(2):177-181. doi: 10.1111/ases.12417. Epub 2017 Aug 30.
We performed Pfannenstiel laparoendoscopic reduced-port bilateral radical nephrectomy on a patient with renal cell carcinoma undergoing hemodialysis. A 4-cm Pfannenstiel incision was made, and a GelPOINT access was inserted. Three trocars were placed through the access platform, and additional 5- and 3-mm trocars were inserted in the umbilicus and paraumbilical area, respectively. After left nephrectomy, right nephrectomy was successfully completed in 401 min, with an estimated blood loss of 70 mL. There were no intraoperative or postoperative complications, and the patient was discharged 10 days postoperatively. The umbilical scar was concealed within the umbilical fold, and the scar from the 3-mm trocar was almost invisible. The Pfannenstiel scar was minimal and concealed by the patient's underwear. Pfannenstiel laparoendoscopic reduced-port simultaneous bilateral radical nephrectomy is a safe and technically feasible procedure that offers great cosmesis for patients with bilateral renal tumors and end-stage renal disease.
我们对一名正在接受血液透析的肾细胞癌患者实施了经Pfannenstiel切口的腹腔镜减孔双侧根治性肾切除术。做了一个4厘米的Pfannenstiel切口，并插入了GelPOINT通道。通过通道平台置入了3个套管针，另外分别在脐部和脐旁区域插入了5毫米和3毫米的套管针。左肾切除术后，在401分钟内成功完成了右肾切除术，估计失血量为70毫升。术中及术后均无并发症，患者术后10天出院。脐部瘢痕隐藏在脐皱襞内，3毫米套管针的瘢痕几乎不可见。Pfannenstiel切口瘢痕极小，被患者内裤遮盖。经Pfannenstiel切口的腹腔镜减孔同期双侧根治性肾切除术是一种安全且技术上可行的手术，为双侧肾肿瘤和终末期肾病患者提供了良好的美容效果。
