Feasibility of Laparoendoscopic Single-Site Partial Nephrectomy in a Porcine Model
Koo Dong-Hun, 박용현, 정창욱, 정현, 김현회, 이승배,
소속 상세정보
( Koo Dong-Hun )
Seoul National University College of Medicine Department of Urology
박용현 ( Park Yong-Hyun )
Seoul National University College of Medicine Department of Urology
정창욱 ( Jeong Chang-Wook )
Seoul National University Bundang Hospital Department of Urology
정현 ( Jeong Hyeon )
Seoul National University Boramae Medical Center Department of Urology
김현회 ( Kim Hyeon-Hoe )
Seoul National University College of Medicine Department of Urology
이승배 ( Lee Seung-Bae )
Seoul National University Boramae Medical Center Department of Urology
KMID : 0358320110520010044
Abstract
Purpose: We performed laparoendoscopic single-site (LESS) partial nephrectomy in a porcine model with the objectives of overcoming the technical challenges of this surgery and exploring its feasibility.
Materials and Methods: Six partial nephrectomies were performed on a pig aged 5 months, three cases on each kidney, by four surgeons: two urologists with much experience in laparoscopic surgery (E1, E2) and two less-experienced urologists (B1, B2). While under general anesthesia, the swine was placed in a lateral flank position. Umbilical placement of an Octoport was done with a 2.5 cm incision. After dissection of the renal hilum and Gerota’s fascia, a bulldog clamp was applied on the renal artery and parenchymal resection was done. Renorrhaphy was then performed with interrupted sutures with the use of a sliding knot technique.
Results: All six partial nephrectomies were performed successfully after repair of the vascular and collecting system at the resection margin and renorrhaphy without the need to introduce any additional ports. There were no noticeable intra- or postoperative complications. The mean warm ischemic time was 42 minutes (range, 30-60 minutes). The shortest warm ischemic time, 30 minutes, was achieved by using the early unclamping technique during renorrhaphy. The longest warm ischemic time was 60 minutes. The average number of renorrhaphy stitches was 3.2 (range, 2-5).
Conclusions: LESS partial nephrectomy was successfully performed in a porcine model but resulted in a longer ischemic time than that of conventional laparoscopic surgeries. Therefore, further laboratory disciplinary efforts are needed to decrease the warm ischemic time and to improve this surgical technique.
키워드
Kidney neoplasms; Laparoscopy; Nephrectomy
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