Adult urologyIntraoperative laparoscopic renal ultrasonography: Use in advanced laparoscopic renal surgery
Section snippets
Material and methods
All patients undergoing laparoscopic renal procedures requiring ILUS from October 2001 to March 2005 were reviewed. A total of 50 cases, including 35 partial nephrectomies, cryoablation of 6 renal tumors, 6 radical nephrectomies, 2 perinephric explorations, and 1 resection of a renal artery aneurysm were assessed by ILUS.
Partial Nephrectomy
During our early experience with partial nephrectomy, ILUS was not used and successful partial nephrectomies were performed with negative margins. However, all 14 excised tumors were exophytic, with a mean tumor size of 1.6 ± 0.6 cm.7 In contrast, the mean tumor size in the 35 patients in the present study was 3.1 cm (range 1.54 to 8). Also, the collecting system was never entered in our early experience without ILUS, but in our latter experience, the collecting system was entered 22 of 35
Comment
Because ILUS is rarely helpful in standard laparoscopic nephrectomy procedures, published urologic reports of the use of ILUS have been limited to several short reviews in renal surgery.8, 9 As an early proponent of ILUS, Matin and Gill9 reviewed the use of ILUS in lymphocelectomy, renal cyst decortication, nephrolithotomy, and cryosurgery. Gill et al.10 also promoted the use of ILUS in their extensive laparoscopic partial nephrectomy series. Others have similarly indicated an invaluable role
Conclusions
ILUS has become an important adjunct to advanced laparoscopic renal surgical procedures, and, in selected cases, ILUS plays a critical role. With the advancement of laparoscopy into the realm of increasingly complex procedures, its role continues to be defined.
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