Transperitoneal Descending Laparoscopic Nephrectomy: Tunc Technique

Abstract

Introduction:

We are presenting in this video our new modified technique for transperitoneal laparoscopic nephrectomy. We aimed to compare its results with the classical ascending transperitoneal nephrectomy.

Materials and Methods:

The new modified “Tunc” technique ¹ includes a direct upper kidney pole access and early ligation of renal pedicle. The kidney preparation is performed in a descending and more direct access to pedicel. We compared 85 cases performed with the classical technique (group 1) with 98 cases (group 2) performed with the Tunc technique. Patient positioning and trocar sites were the same.

Results:

No significant differences were detected regarding mean patient age, intraoperative blood loss, and duration of hospital stay between the two groups. The difference became statistically significant in comparing the operation times. The mean operation time was 64.9±19.3 minutes and 28.2±7.7 minutes, respectively, in groups 1 and 2 (p=0.001). The mean operation time including right nephrectomies was 68.7±23.4 minutes and 24.2±6.3 minutes, respectively, in groups 1 and 2 (p=0.001). The mean operation time including left nephrectomies was 63.8±17.1 minutes and 33.6±5.1 minutes, respectively, in groups 1 and 2 (p=0.001). Similarly, the mean operation time was significantly shorter in group 2 when analysis was performed among right and left radical and simple nephrectomies between the two groups (p=0.001).

Conclusion:

The Tunc technique with direct upper kidney pole access and early ligation of renal pedicle seems to be significantly facilitating transperitoneal laparoscopic nephrectomy procedures.

No competing financial interests exist

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Runtime of video: 9 mins 49 secs