Hand Assisted Retroperitoneoscopic Nephroureterectomy With the Patient Spread-Eagled: An Approach Through a Completely Supine Position

研究成果: Article

13 引文 (Scopus)

摘要

Purpose: We evaluated the feasibility of hand assisted retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the upper urinary tract with the patient completely supine (spread-eagled). Materials and Methods: From October 2006 to January 2008 hand assisted retroperitoneoscopic nephroureterectomy with open bladder cuff excision was performed in 32 patients with upper tract transitional cell carcinoma. The patient was placed supine with the legs extended and abducted at 45 to 60 degrees, and the arms stretched out to the sides in the spread-eagle position. The patient was secured to the operation table with 3-inch tapes to permit lateral table tilt. The operation was completed via a 7 or 8 cm Gibson incision plus 2 laparoscopic ports. Results: All procedures were successful. The mean time needed for hand assisted retroperitoneoscopic nephroureterectomy and bladder cuff resection was 137.6 minutes. Mean estimated blood loss was 200 ml. Simultaneous transurethral endoscopic procedures were performed in 8 patients. Time to oral intake was 2.1 days and time to ambulation was 2.0 days. No specific complication was related to the position. All patients recovered to normal daily activity uneventfully. Conclusions: Hand assisted retroperitoneoscopic nephroureterectomy with the patient completely supine is feasible and safe. The completely supine position has several advantages, including ease of patient positioning and the ability to perform simultaneous endoscopic procedures. It not only decreases the time and cost of changing position, but also avoids potential risks associated with the lateral decubitus position. Bowel interference with the visual field and mechanical bowel injury are not a concern using this approach.

原文English
頁(從 - 到)1918-1922
頁數5
期刊Journal of Urology
180
發行號5
DOIs
出版狀態Published - 2008 十一月 1

指紋

Supine Position
Hand
Transitional Cell Carcinoma
Urinary Bladder
Operating Tables
Patient Positioning
Eagles
Aptitude
Visual Fields
Urinary Tract
Walking
Leg
Arm
Costs and Cost Analysis
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Urology

引用此文

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abstract = "Purpose: We evaluated the feasibility of hand assisted retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the upper urinary tract with the patient completely supine (spread-eagled). Materials and Methods: From October 2006 to January 2008 hand assisted retroperitoneoscopic nephroureterectomy with open bladder cuff excision was performed in 32 patients with upper tract transitional cell carcinoma. The patient was placed supine with the legs extended and abducted at 45 to 60 degrees, and the arms stretched out to the sides in the spread-eagle position. The patient was secured to the operation table with 3-inch tapes to permit lateral table tilt. The operation was completed via a 7 or 8 cm Gibson incision plus 2 laparoscopic ports. Results: All procedures were successful. The mean time needed for hand assisted retroperitoneoscopic nephroureterectomy and bladder cuff resection was 137.6 minutes. Mean estimated blood loss was 200 ml. Simultaneous transurethral endoscopic procedures were performed in 8 patients. Time to oral intake was 2.1 days and time to ambulation was 2.0 days. No specific complication was related to the position. All patients recovered to normal daily activity uneventfully. Conclusions: Hand assisted retroperitoneoscopic nephroureterectomy with the patient completely supine is feasible and safe. The completely supine position has several advantages, including ease of patient positioning and the ability to perform simultaneous endoscopic procedures. It not only decreases the time and cost of changing position, but also avoids potential risks associated with the lateral decubitus position. Bowel interference with the visual field and mechanical bowel injury are not a concern using this approach.",
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AB - Purpose: We evaluated the feasibility of hand assisted retroperitoneoscopic nephroureterectomy for transitional cell carcinoma of the upper urinary tract with the patient completely supine (spread-eagled). Materials and Methods: From October 2006 to January 2008 hand assisted retroperitoneoscopic nephroureterectomy with open bladder cuff excision was performed in 32 patients with upper tract transitional cell carcinoma. The patient was placed supine with the legs extended and abducted at 45 to 60 degrees, and the arms stretched out to the sides in the spread-eagle position. The patient was secured to the operation table with 3-inch tapes to permit lateral table tilt. The operation was completed via a 7 or 8 cm Gibson incision plus 2 laparoscopic ports. Results: All procedures were successful. The mean time needed for hand assisted retroperitoneoscopic nephroureterectomy and bladder cuff resection was 137.6 minutes. Mean estimated blood loss was 200 ml. Simultaneous transurethral endoscopic procedures were performed in 8 patients. Time to oral intake was 2.1 days and time to ambulation was 2.0 days. No specific complication was related to the position. All patients recovered to normal daily activity uneventfully. Conclusions: Hand assisted retroperitoneoscopic nephroureterectomy with the patient completely supine is feasible and safe. The completely supine position has several advantages, including ease of patient positioning and the ability to perform simultaneous endoscopic procedures. It not only decreases the time and cost of changing position, but also avoids potential risks associated with the lateral decubitus position. Bowel interference with the visual field and mechanical bowel injury are not a concern using this approach.

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