Endoloop-assisted laparoscopic partial nephrectomy

Stephen D W Beck, David A. Lifshitz, Liang Cheng, James E. Lingeman, Arieh L. Shalhav

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Purpose: To determine the safety and feasibility of Endoloop-assisted laparoscopic partial nephrectomy in a large-animal model. Materials and Methods: Twelve female Yucatan mini-pigs underwent either left (N = 6) or right (N = 6) transperitoneal laparoscopic lower-pole nephrectomy following cinching of a 1-0 Vicryl suture loop (Endoloop) proximal to the resected lower pole until ischemic discoloration was achieved. The ischemic lower pole was excised with Endo-scissors and the lower pole removed using a laparoscopic bag. Follow-up involved evaluation under anesthesia with retrograde pyelography and intravenous urography and subsequent sacrifice for pathologic evaluation at 3 (N = 4), 14 (N = 4), or 60 (N = 4) days. Results: All procedures were completed successfully. In two cases, the Endoloop slipped off the retained parenchyma. Both problems were corrected immediately with no sequelae. At sacrifice, all upper-pole renal segments functioned, as shown by urography, and no urinomas or abscesses were found. In one animal, there was moderate hydronephrosis presumably secondary to ureteral scarring, and in another, mild extravasation was demonstrated on the retrograde pyelogram. Conclusion: We were able to perform laparoscopic partial nephrectomy with the Endoloop safely and effectively in the current model. Modification of the Endoloop to allow more controlled pressure application may allow clinical application of this method for polar laparoscopic partial nephrectomy.

Original languageEnglish
Pages (from-to)175-177
Number of pages3
JournalJournal of Endourology
Volume16
Issue number3
StatePublished - 2002

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Urography
Nephrectomy
Urinoma
Polyglactin 910
Hydronephrosis
Abscess
Sutures
Cicatrix
Swine
Anesthesia
Animal Models
Kidney
Safety
Pressure

ASJC Scopus subject areas

  • Urology

Cite this

Beck, S. D. W., Lifshitz, D. A., Cheng, L., Lingeman, J. E., & Shalhav, A. L. (2002). Endoloop-assisted laparoscopic partial nephrectomy. Journal of Endourology, 16(3), 175-177.

Endoloop-assisted laparoscopic partial nephrectomy. / Beck, Stephen D W; Lifshitz, David A.; Cheng, Liang; Lingeman, James E.; Shalhav, Arieh L.

In: Journal of Endourology, Vol. 16, No. 3, 2002, p. 175-177.

Research output: Contribution to journalArticle

Beck, SDW, Lifshitz, DA, Cheng, L, Lingeman, JE & Shalhav, AL 2002, 'Endoloop-assisted laparoscopic partial nephrectomy', Journal of Endourology, vol. 16, no. 3, pp. 175-177.
Beck SDW, Lifshitz DA, Cheng L, Lingeman JE, Shalhav AL. Endoloop-assisted laparoscopic partial nephrectomy. Journal of Endourology. 2002;16(3):175-177.
Beck, Stephen D W ; Lifshitz, David A. ; Cheng, Liang ; Lingeman, James E. ; Shalhav, Arieh L. / Endoloop-assisted laparoscopic partial nephrectomy. In: Journal of Endourology. 2002 ; Vol. 16, No. 3. pp. 175-177.
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AB - Purpose: To determine the safety and feasibility of Endoloop-assisted laparoscopic partial nephrectomy in a large-animal model. Materials and Methods: Twelve female Yucatan mini-pigs underwent either left (N = 6) or right (N = 6) transperitoneal laparoscopic lower-pole nephrectomy following cinching of a 1-0 Vicryl suture loop (Endoloop) proximal to the resected lower pole until ischemic discoloration was achieved. The ischemic lower pole was excised with Endo-scissors and the lower pole removed using a laparoscopic bag. Follow-up involved evaluation under anesthesia with retrograde pyelography and intravenous urography and subsequent sacrifice for pathologic evaluation at 3 (N = 4), 14 (N = 4), or 60 (N = 4) days. Results: All procedures were completed successfully. In two cases, the Endoloop slipped off the retained parenchyma. Both problems were corrected immediately with no sequelae. At sacrifice, all upper-pole renal segments functioned, as shown by urography, and no urinomas or abscesses were found. In one animal, there was moderate hydronephrosis presumably secondary to ureteral scarring, and in another, mild extravasation was demonstrated on the retrograde pyelogram. Conclusion: We were able to perform laparoscopic partial nephrectomy with the Endoloop safely and effectively in the current model. Modification of the Endoloop to allow more controlled pressure application may allow clinical application of this method for polar laparoscopic partial nephrectomy.

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