Intraoperative laparoscopic renal ultrasonography: Use in advanced laparoscopic renal surgery

Fazio, Luke M.; Downey, Dónal B.; Nguan, Christopher; Karnik, Vaishali; Al-Omar, Mohammed A.; Kwan, Kevin; Izawa, Jonathan I.; Chin, Joseph L.; Luke, Patrick

doi:10.1016/j.urology.2006.04.022

Cited by 27 publications

(14 citation statements)

References 9 publications

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“…With ILUS or IOUS, higher ultrasonic frequencies can be used, which enhances tissue resolution. ILUS can provide not only better radiographic images compared with transcutaneous US but also image resolution that may clarify the anatomic details beyond the capacity of CT [9]. …”

Section: Discussionmentioning

confidence: 99%

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Kang¹,

Niu²,

Zhang³

et al. 2012

Urol Int

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Objective: To evaluate the value of intraoperative laparoscopic ultrasonography (ILUS) in retrolaparoscopic nephron-sparing surgery. Methods: A total of 81 cases were studied during a 5-year period: 38 patients with a benign renal tumor who underwent enucleation of the tumor and 43 patients with a suspected malignant renal tumor who underwent wedge resection of the tumor. ILUS was used to evaluate renal perfusion, locate the tumor, precisely delineate the tumor border, characterize the tumor, and look for any suspected satellite renal masses. Results: All procedures were successful without conversion to open surgery. The mean operating time was 106 min for enucleation (range 70– 150 min) and 114 min for wedge resection (range 80– 235 min). The mean size of benign tumors was 4.02 cm and that of malignant tumors was 3.13 cm, and all margins were negative. An additional renal artery branch was detected in 11 patients. In 2 cases the operative procedure was changed based on the ILUS findings. No satellite lesion was found in any of the patients with malignant tumors. Conclusions: ILUS provides significant benefit in retrolaparoscopic nephron-sparing surgery. In a number of situations, especially endogenic lesions, it is an essential surgical tool.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Kang¹,

Niu²,

Zhang³

et al. 2012

Urol Int

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“…Intraoperative ultrasound was used to identify the borders of the mass, rule out other renal lesions, and assess renal vascular flow, as previously described by our group. 21 Prior to resection, 0.5 mg/kg IV mannitol was administered and both renal arteries and veins were clamped. Doppler ultrasound was used to confirm there was no flow throughout the kidney.…”

Section: Technical Description Of Ecrmentioning

confidence: 99%

Early clamp release during laparoscopic partial nephrectomy: Implications for preservation of renal function

Campbell

Chan²,

Luke

2017

CUAJ

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Introduction: Intraoperative warm ischemic time (WIT), associated with hilar clamping during partial nephrectomy (PN), is an established modifiable risk factor for renal dysfunction. We assessed early clamp release (ECR) as a strategy to reduce WIT and assess its impact on renal function and bleeding. Methods: We retrospectively assessed patients who underwent minimally invasive PN by a single surgeon at our centre since December 2011. Comparing the standard technique to an ECR modification, WIT, complications, change in estimated glomerular filtration rate (eGFR), and change in differential function as demonstrated by MAG-3 nuclear renography were assessed. Followup blood work and renograms were performed at 6-12 weeks postoperatively and compared to baseline in 70 patients (35 ECR: 35 control). Results: The ECR and control groups were similar in age, sex, and tumour size, with only patient weight being higher in the ECR group (91.6 vs. 81.6 kg; p<0.05). WIT was significantly lower in ECR group compared to control (18.8 vs. 31.5 minutes; p<0.05). Although there was no significant difference in change from baseline eGFR in the early postoperative period (Day 3) or in followup (6-12 weeks), the control group had a significantly greater loss of ipsilateral renal function from baseline compared to the ECR group (9 vs. 4% change; p<0.05). Blood loss and complication rate were similar between groups. Conclusions: The ECR technique offers a safe, reproducible alternative that reduces WIT during laparoscopic PN. ECR demonstrates a reduction in overall ipsilateral renal dysfunction, without increasing complication or intraoperative bleeding risk.

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“…Newer probes allow the surgeon to directly control the probe with standard robotic instruments (1). Intraoperative ultrasonography has proven useful during partial nephrectomy for tumor identification to facilitate complete resection (2,3). It is useful in parenchymal incision planning.…”

Section: Editorial Commentmentioning

confidence: 99%

Robotic nephrolithotomy and pyelolithotomy with utilization of the robotic ultrasound probe

et al. 2014

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_______________________________________________________________________________________Introduction: The treatment of large renal stones in children can be challenging often requiring combination therapy and multiple procedures. The purpose of this video is to describe our technique of robotic nephrolithotomy and pyelolithotomy for complex renal stone disease in children, and to demonstrate the utility of the robotic ultrasound probe to aid with stone localization. Materials and Methods: Robotic nephrolithotomy/pyelolithotomy was carried out in four consecutive patients. A robotic ultrasound probe (Hitachi-Aloka, Tokyo, Japan) under console surgeon control was used in all cases. Results: Two patients underwent robotic pyelolithotomy, one patient underwent robotic nephrolithotomy, whilst the fourth patient underwent robotic pyelolithotomy and nephrolithotomy along with Y-V pyeloplasty for concurrent ureteropelvic junction obstruction. Mean operative time, blood loss and hospital stay was 216 minutes, 37.5 mL and 2 days, respectively. The robotic ultrasound probe aided identification of calculi within the kidney in all cases. For nephrolithotomy it was helpful in planning the incision for nephrotomy. After nephrotomy or pyelotomy, stones were removed using a combination of robotic Maryland forceps, fenestrated grasper or Prograsp. Antegrade nephroscopy introduced through a laparoscopic port was used in all patients for confirmation of residual stone status. Two patients did not require a ureteral stent in the post-operative period. One patient had a minor complication (Clavien Grade 2 -dislodged malecot catheter). All patients were stone free at last follow-up. Conclusions: Robotic nephrolithotomy and pyelolithotomy with utilization of the robotic ultrasound probe offers a onestop solution for complex renal stones with excellent stone-free rates.

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Intraoperative laparoscopic renal ultrasonography: Use in advanced laparoscopic renal surgery

Cited by 27 publications

References 9 publications

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Intraoperative Ultrasonography: A Useful Tool In Retrolaparoscopic Nephron-Sparing Surgery

Early clamp release during laparoscopic partial nephrectomy: Implications for preservation of renal function

Robotic nephrolithotomy and pyelolithotomy with utilization of the robotic ultrasound probe

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