“Off-Clamp, Non-renorrhaphy” Laparoscopic Partial Nephrectomy with Perirenal Fat and Gerota's Fascia Reapproximation: Initial Experience and Perioperative Outcomes

Kim, Taek Sang; Oh, Jin Young; Rhew, Hyun Yul

doi:10.1089/lap.2013.0333

Cited by 11 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our explanations are: firstly, partial nephrectomy cases made via off clamp technique, secondly, suturing is a well-known time consuming part for the inexperienced learners ( 19 ). As in our patients, off-clamp laparoscopic partial nephrectomy was suggested in cases with low renal nephrometry score ( 20 , 21 ). The evaluation of aforementioned studies suggests that apparently a complete consensus has not been reached so far regarding laparoscopic learning curve.…”

Section: Discussionsupporting

confidence: 52%

Should oncological cases of upper urinary system be excluded at the beginning of the laparoscopic learning curve?

et al. 2015

View full text Add to dashboard Cite

Purpose:The place of oncological cases of upper urinary system in the laparoscopic learning curve was investigated.Materials and Methods:A total of 139 patients from two different centers underwent laparoscopic operations and were included in this retrospective study.Results:Mean operative times for oncological, and non-oncological cases were 101.3 (range 60-450), and 102.7 (45-490) minutes respectively. Fourty-two (31.3 %) patients were oncological cases. In 4 oncological cases, the surgeons switched to open surgery because of massive bleeding and six (14.2 %) oncological cases required blood transfusions during peri/postoperative periods. Pulmonary embolism was observed in one oncological case. In one non-oncological case, the surgeon switched to open surgery because of intestinal perforation and 10 (9.7 %) non-oncological cases needed blood transfusions during peri/postoperative periods. In addition, some complications such as intestinal perforation (n=1), mechanical ileus (n=1), and pulmonary embolism (n=1) were observed during postoperative period. Intestinal perforation was repaired using laparoscopic (n=1) method. Mechanical ileus was approached with open surgical technique. Mean hospital stay of the patients in the oncological and non-oncological series were 4.5 (3-23) and 4.5 (3-30) days respectively.Conclusion:We think that renal oncological cases should be included in the spectrum of laparoscopic indications even at the beginning of the learning curve. Certainly, we still share the opinion that cancer cases which require highly challenging surgeries like radical cystectomy, and prostatectomy should be postponed till to gaining of higher level of experience.

show abstract

Section: Discussionsupporting

confidence: 52%

Should oncological cases of upper urinary system be excluded at the beginning of the laparoscopic learning curve?

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The perioperative eGFR preservation at 1 month and 3 months after surgery was 88.9% and 87.3%, respectively (8). In laparoscopic or robotic surgeries, perioperative eGFR preservation was 96.9-100% for highly selected patients (18)(19)(20). In our study, the eGFR preservation at 5 days, 1 month, and 3 months after surgery was 95.3%, 91.0%, and 90.7%, respectively.…”

Section: Discussionsupporting

confidence: 46%

Predictive factors for postoperative renal function after off-clamp, non-renorrhaphy partial nephrectomy

Nakamura¹,

Kameyama²,

Ambe³

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

Background: There is limited information on perioperative renal function during off-clamp, nonrenorrhaphy open partial nephrectomy. Therefore, this retrospective study aimed to identify predictive factors of perioperative decline in renal function after off-clamp, non-renorrhaphy open partial nephrectomy. Methods: Clinical records of 138 patients with renal tumors who underwent off-clamp, non-renorrhaphyopen partial nephrectomy at our institution were reviewed. Off-clamp, non-renorrhaphy partial nephrectomy was performed using a soft coagulation system. Perioperative estimated glomerular filtration rate (eGFR) preservation was calculated, and predictors were identified using multivariate regression analysis at 5 days, 1 month, and 3 months after surgery. Results:The median operation time was 122 minutes, and the median volume of estimated blood loss was 155 mL. The mean eGFR preservation at 5 days, 1 month, and 3 months after surgery was 95.3%, 91.0%, and 90.7%, respectively. Estimated blood loss was an independent predictor of perioperative decline in eGFR

show abstract

“…Renorrhaphy should be performed in a time-sensitive manner due to its impact on WIT. In any case, the shortening of WIT is generally considered as a crucial factor for the preservation of renal function in the context of PN [ 11 23 ]. Renal reconstruction after tumor excision in OPN has usually been performed with traditional tied-suture renorrhaphy.…”

Section: Discussionmentioning

confidence: 99%

“…It was revealed that TLCU renorrhaphy could provide better several advantages than OLIF renorrhaphy in terms of WIT, hospital stay, and preservation of renal function measured by eGFR. Contrary to the renorrhaphy approaches mentioned above, "Off-Clamp, Non-renorrhaphy" technique was more recently introduced in LPN [ 23 ]. In this technique, biologic hemostatic agents such as FLOSEAL and TISSEEL are used in the bed of the excised mass as a hemostatic method following renal mass excision without renal artery clamping, and the perirenal fat and Gerota's fascia reapproximation are performed using 3-0 Vicryl continuous sutures without renorrhaphy.…”

Section: Discussionmentioning

confidence: 99%

The clinical application of the sliding loop technique for renorrhaphy during robot-assisted laparoscopic partial nephrectomy: Surgical technique and outcomes

Kim

Lee

et al. 2015

Korean J Urol

View full text Add to dashboard Cite

PurposeTo report the initial clinical outcomes of the newly devised sliding loop technique (SLT) used for renorrhaphy in patients who underwent robot-assisted laparoscopic partial nephrectomy (RALPN) for small renal mass.Materials and MethodsWe reviewed the surgical videos and medical charts of 31 patients who had undergone RALPN with the SLT renorrhaphy performed by two surgeons (CWJ and CK) between January 2014 and October 2014. SLT renorrhaphy was performed after tumor excision and renal parenchymal defect repair. Assessed outcomes included renorrhaphy time (RT), warm ischemic time, perioperative complications, and perioperative renal function change. RT was defined as interval from the end of bed suture to the renal artery declamping.ResultsIn all patients, sliding loop renorrhaphy was successfully conducted without conversions to radical nephrectomy or open approaches. Mean renorrhaphy and warm ischemic time were 9.0 and 22.6 minutes, respectively. After completing renorrhaphy, there were no adverse events such as dehiscence of approximated renal parenchyma, renal parenchymal tearing, or significant bleeding. Furthermore, no postoperative complications or significant renal function decline were observed as of the last follow-up for all patients. The limitations of this study include the small volume case series, the retrospective nature of the study, and the heterogeneity of surgeons.ConclusionsFrom our initial clinical experience, SLT may be an efficient and safe renorrhaphy method in real clinical practice. Further large scale, prospective, long-term follow-up, and direct comparative studies with other techniques are required to confirm the clinical applicability of SLT.

show abstract

“Off-Clamp, Non-renorrhaphy” Laparoscopic Partial Nephrectomy with Perirenal Fat and Gerota's Fascia Reapproximation: Initial Experience and Perioperative Outcomes

Abstract: OCNR-LPN with the perirenal fat and Gerota's fascia reapproximation technique is feasible. Our initial experience with OCNR-LPN demonstrates encouraging results of minimal renal function loss and complications.

Cited by 11 publications

References 26 publications

Should oncological cases of upper urinary system be excluded at the beginning of the laparoscopic learning curve?

Should oncological cases of upper urinary system be excluded at the beginning of the laparoscopic learning curve?

Predictive factors for postoperative renal function after off-clamp, non-renorrhaphy partial nephrectomy

The clinical application of the sliding loop technique for renorrhaphy during robot-assisted laparoscopic partial nephrectomy: Surgical technique and outcomes

Contact Info

Product

Resources

About