NEPHRON-SPARING LAPAROSCOPIC SURGERY - TECHNIQUES TO CONTROL THE RENAL PEDICLE AND MANAGE PARENCHYMAL BLEEDING

被引:20
作者
KLETSCHER, BA [1 ]
LAUVETZ, RW [1 ]
SEGURA, JW [1 ]
机构
[1] MAYO CLIN & MAYO FDN,DEPT UROL,ROCHESTER,MN 55905
关键词
D O I
10.1089/end.1995.9.23
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Laparoscopic nephron-sparing surgery has been limited by several factors, including problems in the control of the vascular pedicle and the management of parenchymal bleeding. In an effort to improve the efficacy of laparoscopic nephron-sparing surgery, we developed and tested several techniques to control and manage intraoperative renal bleeding while performing 30 laparoscopic anatrophic nephrolithotomies using the porcine model. Control of the renal pedicle and management of bleeding included the use of the following: (1) extracorporeally applied atraumatic vascular pedicle clamp; (2) Argon Beam Coagulator to perform the capsulotomy; (3) electrocautery scissors to perform the nephrotomy; (4) Gelfoam welded to the cut surface of the parenchyma with the argon beam coagulator; (5) Surgicel welded to the outer surface of the kidney with the Coagulator; and (6) laparoscopically applied holster sutures to further stabilize the renal unit. All animals tolerated the procedure well and survived to their appointed date of sacrifice. We conclude that these techniques may improve the efficacy of laparoscopic renal surgery, including nephron-sparing procedures.
引用
收藏
页码:23 / 30
页数:8
相关论文
共 10 条
[1]  
Albala D M, 1992, Semin Urol, V10, P146
[2]  
Clayman R V, 1991, J Laparoendosc Surg, V1, P343, DOI 10.1089/lps.1991.1.343
[3]   LAPAROSCOPIC NEPHRECTOMY - INITIAL CASE-REPORT [J].
CLAYMAN, RV ;
KAVOUSSI, LR ;
SOPER, NJ ;
DIERKS, SM ;
MERETYK, S ;
DARCY, MD ;
ROEMER, FD ;
PINGLETON, ED ;
THOMSON, PG ;
LONG, SR .
JOURNAL OF UROLOGY, 1991, 146 (02) :278-282
[4]   LAPAROSCOPIC RENAL BIOPSY VIA RETROPERITONEAL APPROACH [J].
GAUR, DD ;
AGARWAL, DK ;
KHOCHIKAR, MV ;
PUROHIT, KC .
JOURNAL OF UROLOGY, 1994, 151 (04) :925-926
[5]   LAPAROSCOPIC PYELOPLASTY [J].
KAVOUSSI, LR ;
PETERS, CA .
JOURNAL OF UROLOGY, 1993, 150 (06) :1891-1894
[6]  
KAVOUSSI LR, 1992, J UROLOGY, V1147, P426
[7]   ACUTE HEMOSTASIS DURING LAPAROSCOPIC PROCEDURES - METHOD FOR INTRAOPERATIVE APPLICATION OF HEMOSTATIC MATERIAL [J].
KERBL, K ;
CLAYMAN, RV .
JOURNAL OF UROLOGY, 1994, 151 (01) :109-110
[8]   LAPAROSCOPIC ABLATION OF SYMPTOMATIC RENAL CYSTS [J].
RUBENSTEIN, SC ;
HULBERT, JC ;
PHARAND, D ;
SCHUESSLER, WW ;
VANCAILLIE, TG ;
KAVOUSSI, LR .
JOURNAL OF UROLOGY, 1993, 150 (04) :1103-1106
[9]   LAPAROSCOPIC DISMEMBERED PYELOPLASTY [J].
SCHUESSLER, WW ;
GRUNE, MT ;
TECUANHUEY, LV ;
PREMINGER, GM .
JOURNAL OF UROLOGY, 1993, 150 (06) :1795-1799
[10]   LAPAROSCOPIC PARTIAL NEPHRECTOMY - INITIAL CASE-REPORT FOR BENIGN DISEASE [J].
WINFIELD, HN ;
DONOVAN, JF ;
GODET, AS ;
CLAYMAN, RV .
JOURNAL OF ENDOUROLOGY, 1993, 7 (06) :521-526