Partial Nephrectomy

Partial nephrectomy is a technically difficult operation, and is probably the most challenging laparoscopic renal procedure. Hand-assisted laparoscopic and standard laparoscopic (both transperitoneal and retroperitoneal) approaches have performed with success, with an even wider variety of maneuvers for collecting system closure and hemostasis. There have been four published series of hand-assisted laparoscopy partial nephrectomy for renal masses suspicious for malignancy (Table 3) (24-27). In none of the series were any final margins positive, although in the experience of Brown and associates additional resection was required in five patients based upon intraoperative frozen sections. All procedures were completed laparoscopically except for one conversion to open surgery in the series of Stifelman and associates. In the series of Wolf and associates, two of procedures were performed with standard laparoscopy and one was converted to hand-assisted laparoscopy from standard laparoscopy.

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