Deshmukh Chaitanya Sharad, Ganpule Arvind P, Islam Mohammad Rafiqul, Sabnis Ravindra B, Desai Mahesh R
Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, Gujarat, India.
Department of Urology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
J Minim Access Surg. 2019 Oct-Dec;15(4):305-310. doi: 10.4103/jmas.JMAS_124_18.
To construct and validate a cost-effective indigenously made retrieval system (Modified Nadiad bag) in minimal access urology.
The components of the modified Nadiad bag are a polyethylene roll, fishnet thread, and a 5 Fr ureteral catheter. The bag is indigenously made in our institute and used for organ retrieval after proper sterilization. The video recordings of entrapments and retrievals done over the past few months were reviewed. The procedures under review in which the bag was used were: Robot Assisted Radical Prostatectomy (50 cases), laparoscopic radical nephrectomy (50 cases), laparoscopic simple nephrectomy (50 cases) and laparoscopic adrenalectomy (18 cases). We also compared the retrieval time with experts and novices.
The retrieval times, the organ size (largest dimension) and specimen weight were records for each case. Multivariate analysis of the data was done and we extrapolated the retrieval time with organ size, specimen weight and expertise of the surgeon. There was no significant difference among expert surgeons and novice surgeons with regards to retrieval times (p value = 0.29), with regards to organ size (p value = 0.83) and with regards to specimen weight (p value = 0.99).
Our design of retrieval system offers a cost-effective option which is easy to make, without the risk of tumor seeding and without the need for separate access sheath. It's a retrieval system which has proved its efficacy in laparoscopic as well as robotic procedures with no bearing on the expertise of the surgeon involved.
构建并验证一种用于微创泌尿外科的具有成本效益的国产取出系统（改良纳迪德袋）。
改良纳迪德袋的组件包括聚乙烯卷、鱼网线和一根5F输尿管导管。该袋子由我们研究所自制，经适当消毒后用于器官取出。回顾了过去几个月进行的圈套和取出过程的视频记录。接受审查且使用该袋子的手术包括：机器人辅助根治性前列腺切除术（50例）、腹腔镜根治性肾切除术（50例）、腹腔镜单纯肾切除术（50例）和腹腔镜肾上腺切除术（18例）。我们还比较了专家和新手的取出时间。
记录了每例病例的取出时间、器官大小（最大直径）和标本重量。对数据进行多变量分析，并根据器官大小、标本重量和外科医生的专业水平推断取出时间。在取出时间方面（p值 = 0.29）、器官大小方面（p值 = 0.83）和标本重量方面（p值 = 0.99），专家外科医生和新手外科医生之间没有显著差异。
我们的取出系统设计提供了一种经济高效的选择，易于制作，没有肿瘤种植的风险，也无需单独的接入鞘。这是一种在腹腔镜和机器人手术中均已证明其有效性的取出系统，与所涉及外科医生的专业水平无关。
