MedicGo
Two Applications for Laparoscopic Combined Ventral and Dorsal Side Approach in the Lateral Decubitus Position: (1) Right-Modified Retroperitoneal Lymph Node Dissection, (2) Nephrectomy for Horseshoe Kidney.
Metadata
Journalurology1.924Date
2020 Jun 04
4 months ago
Type
Video-Audio Media
Volume
2020-Sep / 143 : 263-265
Author
Fujiwara H 1, Ogawa K 2, Kanamaru S 2, Tamaki M 3, Ito N 3
Affiliation
  • 2. Department of Urology, Kobe City Nishi-Kobe Medical Center, Kobe City, Hyogo, Japan.
  • 3. Department of Urology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Wakayama, Japan.
Doi
PMIDMESH
Abstract
BACKGROUND: Laparoscopic retroperitoneal lymph node dissection (RPLND) in metastatic testicular cancer is a technically challenging procedure. In right-modified RPLND, retrocaval lymph nodes are often not visible and cannot be adequately dissected using only the transperitoneal approach. In laparoscopic nephrectomy (LN) for horseshoe kidney, the kidney cannot be sufficiently moved due to its connection to the contralateral kidney, and the isthmus and lower poles have separate blood supplies arising from the aorta or iliac artery. Detection of these vessels is difficult using the transperitoneal approach, and identifying and incising the isthmus is difficult using the retroperitoneal approach.
OBJECTIVE: To present a new surgical transperitoneal approach combining the ventral and dorsal sides in the lateral decubitus position.
MATERIAL: In laparoscopic RPLND, we recently performed paracaval and retrocaval lymph nodes dissection (LND) from the dorsal side even in the transperitoneal approach. Following inter-aortocaval LND, the surgeon and scopist moved from the ventral to dorsal side of the patient and changed the roles of surgical ports. In this approach, the view on the monitor is similar to that in the retroperitoneal approach. We applied this technique to LN for horseshoe kidney.
RESULTS: In RPLND combining ventral and dorsal side approaches, all lymph nodes were visible from various angles and complete dissection became easier without complications. In LN for horseshoe kidney, vessels to the isthmus could not be detected using the ventral side approach only; however, on combining the dorsal side approach all vessels were easily observed. After vessel resection, the median of the isthmus could be incised using the ventral side approach.
CONCLUSION: A combined ventral and dorsal side approach is a feasible, safe, and effective technique for laparoscopic right-modified RPLND or nephrectomy for horseshoe kidney.
Fav
Like
Download
Share
Export
Cite
1.9
Urologyurology
Metadata
LocationUnited States
FromELSEVIER SCIENCE INC

No Data

© 2017 - 2020 Medicgo
Powered by some medical students