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VR-13
(VS)
LAPAROSCOPIC NEPHRON SPARING APPROACH FOR A RENAL MASS
Saban SARIKAYA
1
, Hasan CETIN
1
, Ender OZDEN
1
, Fatih ATAC
2
, Yarkin Kamil YAKUPOGLU
1
, Yakup BOSTANCI
1
and Ali
Faik YILMAZ
1
1) Ondokuz Mayis University School of Medicine, Urology, Samsun, TURKEY - 2) Ada Hospital, Urology, Giresun, TURKEY
PURPOSE
In this video we aimed to present our laparoscopic partial nephrectomy experience on a right-sided kidney mass in a
pediatric patient
MATERIAL AND METHODS
A 14-year-old girl complaining for right-sided flank pain was found to have a 6 cm mass on the right kidney. A
transperitoneal laparascopic partial nephrectomy was planned. The patient was placed in a 60 degrees lateral decubitis
position. Total of 4 ports were placed, one 12 mm on umblicus, one 12 mm and one 5 mm on right midclavicular line,
and one more 5 mm on 2 cm below the xyphoid. Renal artery and vein was released from the surrounding tissues. The
artery which was branching from the main renal artery and feeding the mass was locked by a ‘Hem-o-Loc' clip. After the
margins were scored by electrocautery, two endobulldog clamps were used to control renal artery and vein. Then the
mass was removed from the parenchyma by the aid of a cold scissors. Collecting system and interlobular vascular
structures were controlled by clips. Then the parenchymal defect was repaired with sutures in a continuous fashion. No
bleeding was observed after removal of the bulldog clamps. The mass was taken out by an endobag and a drain was left
in place.
RESULTS
Elapsed time was 113 minutes starting from the insertion of the first and ending by the removal of the last port. Warm
ischemia time was 16 minutes and estimated blood loss was 150 mL. The drain was removed on the postoperative
second day and then the patient was discharged home. The pathologic examination of the mass revealed a metanephric
adenoma.
CONCLUSIONS
In selected pediatric oncologic cases, laparoscopic partial nephrectomy is an alternative surgical approach.