Intact specimen extraction during renal laparoscopy: Muscle-splitting versus muscle-cutting incision

Purpose: To determine whether a muscle-splitting extraction incision decrea ses patient morbidity after renal laparoscopic surgery. Patients and Methods: Twenty-one patients undergoing laparoscopic simple ne phrectomy, radical nephrectomy, or nephroureterectomy had intact specimen e xtraction through a muscle-splitting incision. The operative and recovery d ata of these patients were retrospectively compared with those of a matched cohort of 21 patients who underwent specimen extraction through a muscle-c utting incision. With the exception of a greater percentage of male patient s in the muscle-cutting group (86% v 52%), there were no statistically sign ificant differences between the two groups. Results: In the muscle-splitting and muscle-cutting groups, there was no si gnificant differences in regard to analgesic use (9.0 +/- 6.6 mg of morphin e sulfate equivalent v 7.9 +/- 4.9; P < 0.51), hospital stay (31.2 hours v 30 hours; P < 0.79), recovery (6.7 +/- 4.7 days v 5.7 +/- 4.7 day ; P < 0.3 8), or convalescence (4.2 +/- 2.2 weeks v 4.1 +/- 2.0 weeks; P < 0.90). Conclusion: A muscle-splitting incision for intact renal specimen extractio n does not necessarily decrease postoperative morbidity compared with a mus cle-cutting extraction.