Shengkun Sun

Temporary Balloon Occlusion of Inferior Vena Cava in Resection of Renal Tumor With Vena Cava Thrombus Extension

OBJECTIVES To investigate a novel and effective method to occlude the inferior vena cava (IVC) during surgical management of a renal tumor with a tumor thrombus extension into the IVC. METHODS We retrospectively reviewed the records of 10 patients with renal cell carcinoma or renal angiomyolipoma with tumor thrombus extending into the IVC who had undergone surgical intervention at our institute from May 2005 to May 2006. The balloon occlusion of the IVC was performed during surgery to decrease the risk of pulmonary embolism. RESULTS One patient could not tolerate the test occlusion of the IVC and the procedure was converted to IVC-right atrium bypass. The remaining 9 patients successfully underwent nephrectomy and thrombectomy with the help of temporary balloon obstruction of the IVC without perioperative mortality or morbidity. The blood pressure and circulatory status were stably maintained during occlusion of the IVC. CONCLUSIONS Temporary balloon occlusion of the IVC is a simple and reliable technique that decreases the risk of pulmonary embolism and facilitates the resection of renal tumor with levels II and III IVC thrombus.

Retroperitoneal laparoendoscopic single-site radical nephrectomy using a low-cost, self-made device: initial experience with 29 cases.

Objectives. To introduce a low-cost, self-made device for single-port retroperitoneal laparoscopic radical nephrectomy and to evaluate outcomes compared with conventional laparoscopy after initial experience using this device. Methods. Twenty-nine renal cancer patients underwent retroperitoneal laparoendoscopic single-site radical nephrectomy using a self-made single-port device with multiple manipulation channels for passage of routine laparoscopic instruments and specimen removal. A control group of 29 patients who were matched by age, gender, and cancer stage underwent conventional laparoscopy. Outcomes were analyzed retrospectively. Results. There were no significant differences in age, gender, body mass index, T stage, and maximum tumor diameter between groups (P > .05). The laparoendoscopic single-site surgery group had a significantly shorter duration of postoperative hospitalization than the conventional laparoscopy group (7.14 ± 1.38 days vs 8.17 ± 1.54 days, P = .009). Conclusions. Retroperitoneal laparoscopic radical nephrectomy using our self-made single-port device appears to be a feasible, safe, and low-cost surgical strategy.

Single-Port Laparoscopic Retroperitoneal Surgery Using a Modified Single-Port Device in Urology

Objectives: To investigate the use of a flexible instrument platform in performing single-port laparoscopic retroperitoneal urologic surgeries and to verify the safety and feasibility of these surgeries. Methods: The homemade instrument platform consisted of two control loops and a powder-free surgical glove to form multichannels. 56 patients underwent this kind of single-port surgery for different urologic diseases, including radical nephrectomy in 31 patients, nephroureterectomy in 7 patients, partial nephrectomy in 8 patients, living donor nephrectomy in 4 patients, adrenalectomy in 3 patients, renal cyst surgery in 2 patients and ureterolithotomy in 1 patient. Results: All surgeries were completed successfully with no switch to conventional laparoscopic or open surgery. The mean hospital stay was 13.13 days (range 6-36). All patients were satisfied without major complications. Conclusions: Retroperitoneal laparoendoscopic single-site surgery using our cost-effective homemade instrument platform appears to be a feasible and safe surgical strategy to perform retroperitoneal laparoscopic urologic surgery.

MP08-09 TRANSURETHRAL DENUDATION OF THE BLADDER MUCOSA BY A NEEDLE ELECTRODE: SHEDDING NEW LIGHT ON AN OLD TECHNIQUE

Although the procedure of denudation of the bladder mucosa was developed over 50 years to treat patients with low-grade non-muscle invasive bladder cancer, this technique was almost abandoned because of several reasons: performed by open surgery, severe bladder hemorrhage, urinary extravasation, bladder contracture, hydronephrosis. Recently, needle electrode proved to be a useful tool in accurate transurethral resection of bladder tumor (ATURBT). INTRODUCTION