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V50 Renal pedicle injuries during minimally invasive partial nephrectomies
V50
Renal pedicle injuries during minimally invasive partial nephrectomies Eur Urol Suppl 2016;15(3);eV50
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Ozgor F., Ucpinar B., Ayranci A., Erbin A., Kandemir E., Berberoglu A.Y., Binbay M., Burak Ucpinar Haseki Training and Research Hospital, Dept. of Urology, Istanbul, Turkey INTRODUCTION & OBJECTIVES: Renal pedicle injury during laparoscopic and robotic partial nephrectomies is one of the most frightening situations, which may result with an unnecessary nephrectomy or conversion to open surgery. In the present video, management of renal vein and artery injuries during laparoscopic and robotic partial nephrectomies are demonstrated. MATERIAL & METHODS: Renal artery injury (Case 1; during laparoscopic partial nephrectomy) and renal vein injuries (Case 2 and 3; during laparoscopic partial nephrectomy, Case 4; during robotic partial nephrectomy) were occurred. In case 1, renal segmental artery was damaged in right kidney during dissection of segmental arteries. Defect at segmental artery was repaired with a 6/0 PDS. In case 2 and 3, renal vein in right kidney was damaged during pedicle dissection and putting a stich with 6/0 PDS controlled bleeding in Case 2. Applying pressure on the damaged part achieved hemostasis in Case 3 and no sutures were placed. In case 4, renal vein in right kidney was damaged and again, putting a stich with 6/0 PDS controlled bleeding. RESULTS: All cases neither converted to open surgery nor underwent total nephrectomy. The affect of pedicule injury on operation time was 12 minutes, 7 minutes, 20 minutes and 8 minutes for case 1, case 2, case 3 and case 4 subsequently. Blood loss occured from vessel injury was 200 cc, 150 cc, 250 cc and 150 cc in case 1, case 2, case 3 and case 4 subsequently. No complication was seen during postoperative period. CONCLUSIONS: Renal pedicle injuries during laparoscopic or robotic partial nephrectomis can be managed in hands of experienced surgeons, without converting to open surgery or performing an unnecessary nephrectomy.
Renal pedicle injuries during minimally invasive partial nephrectomies Eur Urol Suppl 2016;15(3);eV50
Print! Print!
Ozgor F., Ucpinar B., Ayranci A., Erbin A., Kandemir E., Berberoglu A.Y., Binbay M., Burak Ucpinar Haseki Training and Research Hospital, Dept. of Urology, Istanbul, Turkey INTRODUCTION & OBJECTIVES: Renal pedicle injury during laparoscopic and robotic partial nephrectomies is one of the most frightening situations, which may result with an unnecessary nephrectomy or conversion to open surgery. In the present video, management of renal vein and artery injuries during laparoscopic and robotic partial nephrectomies are demonstrated. MATERIAL & METHODS: Renal artery injury (Case 1; during laparoscopic partial nephrectomy) and renal vein injuries (Case 2 and 3; during laparoscopic partial nephrectomy, Case 4; during robotic partial nephrectomy) were occurred. In case 1, renal segmental artery was damaged in right kidney during dissection of segmental arteries. Defect at segmental artery was repaired with a 6/0 PDS. In case 2 and 3, renal vein in right kidney was damaged during pedicle dissection and putting a stich with 6/0 PDS controlled bleeding in Case 2. Applying pressure on the damaged part achieved hemostasis in Case 3 and no sutures were placed. In case 4, renal vein in right kidney was damaged and again, putting a stich with 6/0 PDS controlled bleeding. RESULTS: All cases neither converted to open surgery nor underwent total nephrectomy. The affect of pedicule injury on operation time was 12 minutes, 7 minutes, 20 minutes and 8 minutes for case 1, case 2, case 3 and case 4 subsequently. Blood loss occured from vessel injury was 200 cc, 150 cc, 250 cc and 150 cc in case 1, case 2, case 3 and case 4 subsequently. No complication was seen during postoperative period. CONCLUSIONS: Renal pedicle injuries during laparoscopic or robotic partial nephrectomis can be managed in hands of experienced surgeons, without converting to open surgery or performing an unnecessary nephrectomy.