Laparoscopic versus open partial nephrectomy

Hand-assisted laparoscopic partial nephrectomy after 60 cases: comparison with open partial nephrectomy

“…Initial reports of increased operative time associated with the laparoscopic procedure [7,14] have been refuted with increased experience with the technique [15], with Bhayani [16] reporting a relatively short learning curve in surgeons who have finished a laparoendoscopic fellowship. To identify a learning curve in our HALPN series, the 60 cases were divided into thirds: first, middle, and most recent 20 cases.…”

Laparoscopic Partial Nephrectomy – Current State of the Art

“…In this model, LPN was favorable to OPN, laparoscopic or percutaneous ablation, active surveillance, and nonsurgical management with observation. A direct financial analysis conducted in a retrospective Canadian study demonstrated a lower total hospital cost after LPN (4839 dollars ± 1551 dollars vs. 6297 dollars ± 2972 dollars; p < 0.05) when compared to OPN [95]. Similarly, a retrospective metaanalysis of 2745 procedures (OPN, LPN, and RPN) confirmed that despite similar OR times, LPN was more cost effective than OPN because of a shorter length of hospital stay.…”

“…Similarly, Beasley et al [95] retrospectively compared the result of laparoscopic PN to OPN using a tumor size-matched cohort of patients. Although the mean operative time was longer in the laparoscopic group (210 ± 76 minutes versus 144 ± 24 minutes; p < 0.001), the blood loss was comparable between the two groups (250 ± 250 ml vs 334 ± 343 ml; p = not statistically significant).…”

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

“…19,20 The renal hilum and the vessels were identified and isolated. 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.…”