Intact Specimen Extraction During Renal Laparoscopy: Muscle-Splitting versus Muscle-Cutting Incision

Abstract

Purpose

: To determine whether a muscle-splitting extraction incision decreases patient morbidity after renal laparoscopic surgery.

Patients and Methods

: Twenty-one patients undergoing laparoscopic simple nephrectomy, radical nephrectomy, or nephroureterectomy had intact specimen extraction through a muscle-splitting incision. The operative and recovery data of these patients were retrospectively compared with those of a matched cohort of 21 patients who underwent specimen extraction through a muscle-cutting incision. With the exception of a greater percentage of male patients in the muscle-cutting group (86% v 52%), there were no statistically significant differences between the two groups.

Results

: In the muscle-splitting and muscle-cutting groups, there was no significant differences in regard to analgesic use (9.0 ± 6.6 mg of morphine sulfate equivalent v 7.9 ± 4.9; P < 0.51), hospital stay (31.2 hours v 30 hours; P < 0.79), recovery (6.7 ± 4.7 days v 5.7 ± 4.7 days; P < 0.38), or convalescence (4.2 ± 2.2 weeks v 4.1 ± 2.0 weeks; P < 0.90).

Conclusion

: A muscle-splitting incision for intact renal specimen extraction does not necessarily decrease postoperative morbidity compared with a muscle-cutting extraction.