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Korean J Urol Oncol > Volume 11(2); 2013 > Article
The Korean Journal of Urological Oncology 2013;11(2): 89-93.
손가락 끝 박리법을 이용한 손을 이용한 복강경 부분신절제술의 초기 경험
이영익, 김대현, 김지원, 함동엽, 배상락, 박형근, 김형곤, 노용수, 백성현
건국대학교 의학전문대학원 비뇨기과학교실
Initial Experience of Hand-Assisted Laparoscopic Partial Nephrectomy Using Finger-tip Dissection Technique
Young Ik Lee , Dae Hyun Kim , Ji Won Kim , Dong Yeub Ham , Sang Rak Bae , Hyoung Keun Park , Hyeong Gon Kim , Yong Soo Lho , Sung Hyun Paick
Department of Urology, Konkuk University School of Medicine, Seoul, Korea
Published online: August 30, 2013.
ABSTRACT
Purpose:
We reported the initial experience of hand-assisted laparoscopic partial nephrectomy (HALPN) for kidney neoplasm using finger-tip dissection technique.


Materials and Methods:
A total 11 patients with exophytic renal mass who had undergone HALPN for kidney neoplasms. After mobilizing the entire hilum thoroughly, the renal artery was hung with a rubber catheter. When massive bleeding occurred, it was clamped. Surgeon's index finger-tip was used for the mass dissection. After making the incision line 5-10mm from the mass using scissors, the resection plane was gradually deepened bluntly by the finger-tip, which was directed centrally along the grain of the renal pyramids. If large vessels and calyxes were felt by the finger-tip during dissection, they were secured by clipping. The mass was completely removed by pinching off using the fingers.


Results:
Mean patient age was 51.4 years (37-72 years), mean tumor size was 2.1cm (1.0-3.0cm), the mean operation time was 163.4min (120-310min). In only five patients, renal artery was clamped. In these cases, mean ischemic time was 24min (15-30min). All patients had negative resection margins. Mean estimated blood loss was 304.8ml (63-900ml) and two patients required a post-operative blood transfusion. No serious complications occurred.


Conclusions:
The finger-tip dissection technique of renal mass in HALPN is feasible. This technique can allow the easy and safe dissection by the maximizing the tactile sense. (Korean J Urol Oncol 2013;11:89-93)

Key Words: Nephrectomy; Hand-assisted laparoscopy; Dissection; Kidney neoplasms
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