Hand assisted laparoscopic radical nephrectomy for renal carcinoma using anew abdominal wall sealing device

Purpose: We report our initial experience with a hand assisted laparoscopic radical nephrectomy for patients with renal carcinoma, and compare our res ults to those of conventional open radical nephrectomy. Materials and Methods: The clinical data on 6 consecutive patients who unde rwent hand assisted laparoscopic radical nephrectomy for stage T1N0M0 renal cell carcinoma were reviewed. We performed hand assisted laparoscopic surg ery using the new LAP DISC* abdominal wall sealing device. We compared the results of this procedure with those of conventional open radical nephrecto my in 12 patients with stage T1N0M0 renal cell carcinoma. Results: The hand assisted laparoscopic radical nephrectomy for renal carci noma was successfully performed without any major or minor complications in all 6 patients. Mean operation time for the laparoscopic group was signifi cantly longer than that for the open surgery group (303 minutes versus 224 minutes, p = 0.0042). However, no significant difference was observed in me an estimated blood loss for the 2 groups (264 mi. in the laparoscopic group versus 341 mi, in the open surgery group). The frequency of parenteral ana lgesia postoperatively in the laparoscopic group was significantly lower th an that in the open surgery group (16.7% versus 75.0%, p = 0.043). In addit ion, the laparoscopic group seemed to recover more rapidly than the open su rgery group. The abdominal wall sealing device was easy to attach to the ab dominal wall, and allowed rapid hand removal and reinsertion. Conclusions: Our preliminary results indicate that a hand assisted laparosc opic radical nephrectomy with the abdominal wall sealing device is an effec tive and safe surgical procedure, and is less invasive than open radical ne phrectomy.