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使用 LigaSure 设备行全腹腔镜无夹闭肾切除术:初步经验。

Total clipless laparoscopic nephrectomy carried out with the LigaSure device: Preliminary experience.

机构信息

Service d'urologie B, CHU Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Morocco.

Service d'urologie B, CHU Ibn Sina, faculté de médecine et de pharmacie, université Mohamed V, Rabat, Morocco.

出版信息

Prog Urol. 2023 May;33(6):344-347. doi: 10.1016/j.purol.2023.03.006. Epub 2023 Apr 18.

Abstract

BACKGROUND

Total laparoscopic nephrectomy has become the standard method for the removal of diseased kidneys.

OBJECTIVES

The purpose of this study was to evaluate the feasibility of the LigaSure vessel closure system during laparoscopic nephrectomy.

METHODS

From January 2018 to June 2018, the LigaSure device was used in 5 patients undergoing laparoscopic nephrectomy for non functional kidney. Nephrectomy was carried out without the use of clips or sutures for vessel closure. We report intraoperative findings, conversion rates, blood loss, operative time, morbidity, and postoperative outcomes.

RESULTS

Median operative time was 45minutes (range 25 to 60min). Median blood loss was 30mL (range 10 to 50mL). No conversions to open surgery were necessary. No patients experienced major bleeding intraoperatively or postoperatively. All patients left the hospital one day after the procedure. Histopathological examination of the removed kidneys was in favor of chronic non specific pyelonephritis.

CONCLUSIONS

For the treatment of the renal pedicle during total laparoscopic nephrectomy of a destroyed kidney, the LigaSure device appears to be feasible and effective. Our experience is the first to demonstrate the advantages of LigaSure® in laparoscopic nephrectomy: reduction in operating time, blood loss, transfusions and length of stay in hospital.

摘要

背景

全腹腔镜肾切除术已成为切除病变肾脏的标准方法。

目的

本研究旨在评估 LigaSure 血管闭合系统在腹腔镜肾切除术中的可行性。

方法

自 2018 年 1 月至 2018 年 6 月,LigaSure 设备用于 5 例因非功能性肾脏而接受腹腔镜肾切除术的患者。在不使用夹子或缝线进行血管闭合的情况下进行肾切除术。我们报告术中发现、转换率、出血量、手术时间、发病率和术后结果。

结果

中位手术时间为 45 分钟(范围 25 至 60 分钟)。中位出血量为 30 毫升(范围 10 至 50 毫升)。无需转为开放性手术。术中或术后无患者发生大出血。所有患者在手术后一天出院。切除肾脏的组织病理学检查有利于慢性非特异性肾盂肾炎。

结论

对于全腹腔镜肾切除术治疗破坏的肾脏的肾蒂,LigaSure 设备似乎是可行和有效的。我们的经验是首次证明 LigaSure 在腹腔镜肾切除术中的优势:手术时间、出血量、输血和住院时间减少。

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