1 / 20

TECHNIQUE OF LAPAROSCOPIC NEPHRECTOMY

TECHNIQUE OF LAPAROSCOPIC NEPHRECTOMY. Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster Univ) Chairman, Department of Surgery Umm Al-Qura Univ Consultant Urology, King Faisal Specialist Hospital, Jeddah.

dinah
Télécharger la présentation

TECHNIQUE OF LAPAROSCOPIC NEPHRECTOMY

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TECHNIQUE OF LAPAROSCOPIC NEPHRECTOMY Dr. Anmar Nassir, FRCS(C) Fellowship in Andrology (U of Ottawa) Fellowship in EndoUrology and Laparoscopy (McMaster Univ) Chairman, Department of Surgery Umm Al-Qura Univ Consultant Urology, King Faisal Specialist Hospital, Jeddah

  2. There are 4 basic techniques used to create pneumoperitoneum: • blind Veress needle • direct trocar insertion • optical trocar insertion • open laparoscopy Gu¨nenc et al. Surg Laparosc Endosc Percutan Tech, 2005

  3. In 578 laparoscopic procedures: • blind insertion of the Veress needle (group 1, n = 301) • direct trocar insertion with elevation of the rectus sheath using 2 towel clips (group 2, n = 277). Gu¨nenc et al. Surg Laparosc Endosc Percutan Tech, 2005

  4. Results: Total complication rates: • gr 1 = 15.7% (n = 33) • gr 2 = 3.3% (n = 4) (P < 0.05) Conclusion: Direct trocar insertion with elevation of the rectus sheath using 2 towel clips is an easy, safe, and effective technique. Gu¨nenc et al. Surg Laparosc Endosc Percutan Tech, 2005

  5. Having been a Veress needle advocate throughout my career, I am loath to change. However, this scientifically well-done study gives me “pause”; quicker pneumoperitoneum with fewer complications is certainly a compelling argument for considering a change. Ralph V. Clayman, J of urol. Pg 1847. Nov, 2005

  6. Organ retrieval

  7. Organ retrieval • Intact through an enlarged incision • After placement into a sac. • The kidney can be worked out of • an extended trocar site • Pfannenstiel incision. • Morcellation. • The specimen should be placed into LapSac • Ring forceps and a Kocher clamp & removed in small pieces.

More Related