Complications of Hand-Assisted Laparoscopic Urologic Surgery

Hedican, Sean P.

doi:10.1089/089277904323056960

Cited by 19 publications

(11 citation statements)

References 59 publications

(74 reference statements)

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“…The majority of splenic and liver injuries during urologic laparosocpic surgery are minor capsular lesions which usually can be managed laparoscopically [30]. Typically, in the first line usually these injuries are sufficiently controlled with a combination of pressure and the application of oxidized regenerated cellulose, absorbable gelatin sponges and fibrin glue.…”

Section: Management Of Splenic and Liver Injuriesmentioning

confidence: 99%

Intraoperative complications of laparoscopic adrenalectomy

2008

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A laparoscopic or retroperitoneoscopic access to the adrenal gland is the standard of care for adrenalectomy in most cases. Although in laparoscopic adrenalectomy the approach is minimally invasive, the procedure is challenging. This is reflected in the scope of possible complications. The surgeon must consider complications related to the anatomical topography of the adrenal gland, which typically encompasses the complications known from open surgery and complications related to the minimal invasive access. In this topic paper we will address the most frequently encountered complications of adrenalectomy: vascular injuries, injuries of the bowel, pleural tears, and injuries to the liver, spleen and pancreas. Fortunately, these complications occur rarely. However, many of these complications can have devastating consequences. Therefore, it's the surgeon's obligation to be aware of the possible complications he might encounter during laparoscopic adrenalectomy. This awareness is essential for their prevention and it helps the laparoscopic surgeon to identify complications intraoperatively. Intraoperative complications of laparoscopic adrenalectomy Conflict of interest None AbstractA laparoscopic or retroperitoneoscopic access to the adrenal gland is the standard of care for adrenalectomy in most cases. Although in laparoscopic adrenalectomy the approach is minimally invasive, the procedure is challenging. This is reflected in the scope of possible complications. The surgeon must consider complications related to the anatomical topography of the adrenal gland, which typically encompasses the complications known from open surgery and complications related to the minimal invasive access. In this topic paper we will address the most frequently encountered complications of adrenalectomy: vascular injuries, injuries of the bowel, pleural tears, and injuries to the liver, spleen and pancreas. Fortunately, these complications occur rarely. However, many of these complications can have devastating consequences. Therefore, it's the surgeon's obligation to be aware of the possible complications he might encounter during laparoscopic adrenalectomy. This awareness is essential for their prevention and it helps the laparoscopic surgeon to identify complications intraoperatively.2

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Section: Management Of Splenic and Liver Injuriesmentioning

confidence: 99%

Intraoperative complications of laparoscopic adrenalectomy

2008

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“…Hedican [54] reviewed 196 HAL cases at three major medical institutions, in which 18 patients (9.2%) suffered 32 major complications and 28 patients (14.3%) experienced 31 minor complications. The most common major complications were small bowel injury, open conversion to control bleeding, and postoperative reintubation.…”

Section: Complicationsmentioning

confidence: 99%

Laparoscopic partial nephrectomy: Technique, oncologic efficacy, and safety

Johnston¹,

Wolf

2005

Curr Urol Rep

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Laparoscopic partial nephrectomy is emerging as an attractive approach for selected renal masses, but has been performed with significant variability in technique. The procedure's evolution, a merger of proven open techniques with applicable laparoscopic techniques and limitations, is very much a work in progress. Just as long-term follow-up for open nephron-sparing surgery for selected renal masses has demonstrated recurrence-free survival equivalent to radical nephrectomy, a few large series of laparoscopic partial nephrectomy are beginning to surface that demonstrate its clinical efficacy, although duration of follow-up is still too short to make definitive statements. This article reviews the literature and the authors share their experience and preferences in technique, derived from 100 consecutive laparoscopic partial nephrectomies and from their assessment of the acute sealant effectiveness for partial nephrectomy in a large, hypertensive, porcine model that approximates clinical situations. This review aims to assist the urologic surgeon in determining which renal tumors to approach laparoscopically and which surgical approach best fits their laparoscopic expertise.

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“…The tactile feedback and the ability for gentle retraction, dissection, and the compressive abilities of the intraperitoneal hand can further aid the surgeon in more technically challenging cases. 2,4 Moreover, minimally invasive simple nephrectomy and the tedious dissection required in cases where there is more inflammation and fibrosis due to a history of infection or in cases where the patient has a previous history of abdominal surgery can be simplified with the more tactile approach. Despite the fact that the hand-assisted approach has been available since 1997, there is a dearth of outcome data regarding laparoscopic hand-assisted simple nephrectomy.…”

Section: Introductionmentioning

confidence: 99%