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Laparoscopic Nephroureterectomy

  • Jaime Landman
Part of the Current Clinical Urology book series (CCU)

Summary

The gold standard for management of patients with upper ureteral or renal transitional cell carcinoma (TCC), who have two kidneys and normal renal function, is radical nephroureterectomy with excision of an ipsilateral periureteral cuff of bladder. While highly efficacious for disease control, the open nephroureterectomy, which involves a long muscle splitting incision, results in significant pain and an extended convalescence. Laparoscopic radical nephroureterectomy was introduced by Clayman et al. (1). Compared to open nephroureterectomy, the laparoscopic approach results in decreased post-operative analgesic requirements, a shorter hospital stay, and improved convalescence (2–5). Despite these advantages to the patient, there are two drawbacks to the laparoscopic approach: lengthy operative time, and the need for significant laparoscopic experience on the part of the surgeon. These disadvantages may be partially offset by the application of hand-assisted technique for nephroureterectomy. Indeed, hand-assisted nephroureterectomy is the most commonly reported technique for performing minimally invasive nephroureterectomy. Herein are described the techniques for transperitoneal laparoscopic nephroureterectomy and hand-assisted nephroureterectomy. Management options for the distal ureter and ipsilateral bladder cuff are reviewed.

Keywords

Inferior Vena Cava Renal Vein Transitional Cell Carcinoma Harmonic Scalpel Adrenal Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Humana Press, a part of Springer Science+Business Media, LLC, a part of Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jaime Landman
    • 1
  1. 1.Department of UrologyColumbia University Medical CenterNew YorkUSA

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