Advantages Of Laparoscopy
As the open surgical procedure requires extensive mobilization within the retroperitoneum over a large area, it necessitates a large flank or midline incision. The objectives of open surgery can be easily met with minimally invasive technique of laparoscopy (Table 4) (11-13).
Laparoscopy provides optical magnification that facilitates the identification of small lymphatics easily, thus increasing the chances of success with lesser blood loss and operative time.
Postoperative recovery is rapid and hospital stay is short (11-13).
|
No. of renoureteral | ||||||
|
Study (Ref.) |
units |
Approach |
Technique |
Results |
Follow-up |
Comments |
|
Zhang et al. |
7 |
RP |
Nephrolympholysis |
100% |
2-12 mo |
Used 3 ports |
|
(11) |
Hilar stripping Ureterolympholysis |
(mean 6.7 + 4) | ||||
|
Jiang et al. |
6 |
RP |
Nephrolympholysis |
100% |
1-1.6 yr | |
|
(20) |
Hilar stripping Ureterolympholysis | |||||
|
Hemal and |
11 |
RP |
Nephrolympholysis |
Initially chyluria |
6 mo-4.5 yr |
lprolonged drainage |
|
Gupta (12) |
Ureterolympholysis Fasciectomya Nephropexy21 |
subsided in all cases Recurred in two cases because of contralateral side at 1 and 9 mo, respectively which was treated successfully |
linadvertent clipping of a branch of posterior. segmental artery | |||
|
Gomella et al.(3) |
1 |
RP |
Removal of fascia Gerota Stripping of renal hilum |
Chyluria subsided |
2 yr |
Used 4 ports |
|
Chui et al. (2) |
1 |
TP |
Ligation and division of lymphatics of hilum and ureter (hilar stripping and ureterolympholysis) |
Chyluria subsided |
2 yr |
Used 5 ports |
|
aOptional. | ||||||
|
Abbreviations: RR retroperitoneal; TP transperitoneal. | ||||||
Laparoscopy provides optical magnification that facilitates the identification of small lymphatics easily, thus increasing the chances of success with lesser blood loss and operative time.
Retroperitoneal laparoscopic lympholy-sis has an obvious advantage, because the peritoneum is not transgressed at any level thus avoiding the potential complications such as bowel injury and prolonged ileus.
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