OBJECTIVES: To review our technique and experience with laparoscopic radical nephrectomy (LRN) in the obese patient population. Obesity has been considered a potential risk factor for poor outcomes in a variety of surgical procedures and has been considered a relative contraindication to laparoscopy. Since 1996, with increased experience and technical modifications, obesity has not been considered a contraindication for laparoscopy at our institution. METHODS: Retrospective data were obtained for all patients who underwent LRN from January 1997 to December 2000. A body mass index (Quetelet's index) greater than 30 was used to define obese patients. Technical modifications included slightly greater insufflation pressures and a lateral shift in trocar sites. The obese laparoscopic group was compared with the nonobese laparoscopic group. RESULTS: Of 101 patients who underwent LRN, 69 were not obese and 32 were obese. No statistically significant differences were observed in any of the analyzed operative data between the nonobese laparoscopic group and obese laparoscopic group, including a mean operative time of 220 and 242 minutes, respectively. Other factors assessed were the time to ambulation, length of hospital stay, conversion rate to an open procedure, and complication rate, which also demonstrated no statistically significant difference. Only one conversion to an open procedure was required in both the obese and the nonobese laparoscopic groups. CONCLUSIONS: With minor technical modifications, LRN can be safely performed in obese patients. Proper trocar site selection and greater insufflation pressures were critical for success. The differences in the intraoperative and postoperative course of LRN in obese and nonobese patients were not statistically significant. Obesity should not be considered a contraindication to laparoscopic nephrectomy.
OBJECTIVES: To review our technique and experience with laparoscopic radical nephrectomy (LRN) in the obesepatient population. Obesity has been considered a potential risk factor for poor outcomes in a variety of surgical procedures and has been considered a relative contraindication to laparoscopy. Since 1996, with increased experience and technical modifications, obesity has not been considered a contraindication for laparoscopy at our institution. METHODS: Retrospective data were obtained for all patients who underwent LRN from January 1997 to December 2000. A body mass index (Quetelet's index) greater than 30 was used to define obesepatients. Technical modifications included slightly greater insufflation pressures and a lateral shift in trocar sites. The obese laparoscopic group was compared with the nonobese laparoscopic group. RESULTS: Of 101 patients who underwent LRN, 69 were not obese and 32 were obese. No statistically significant differences were observed in any of the analyzed operative data between the nonobese laparoscopic group and obese laparoscopic group, including a mean operative time of 220 and 242 minutes, respectively. Other factors assessed were the time to ambulation, length of hospital stay, conversion rate to an open procedure, and complication rate, which also demonstrated no statistically significant difference. Only one conversion to an open procedure was required in both the obese and the nonobese laparoscopic groups. CONCLUSIONS: With minor technical modifications, LRN can be safely performed in obesepatients. Proper trocar site selection and greater insufflation pressures were critical for success. The differences in the intraoperative and postoperative course of LRN in obese and nonobese patients were not statistically significant. Obesity should not be considered a contraindication to laparoscopic nephrectomy.
Authors: Se Yun Kwon; Jae Jun Bae; Jung Gon Lee; Seock Hwan Choi; Bum Soo Kim; Eun Sang Yoo; Tae Gyun Kwon; Tae-Hwan Kim Journal: Korean J Urol Date: 2011-08-22
Authors: Abdulkadir Tepeler; Tolga Akman; Adem Tok; Mehmet Kaba; Murat Binbay; Ahmet Yaser Müslümanoğlu; Ahmet Tefekli Journal: Urol Res Date: 2012-02-14
Authors: Ken Batai; Alfredo Harb-De la Rosa; Aye Lwin; Fahad Chaus; Francine C Gachupin; Elinora Price; Benjamin R Lee Journal: Clin Genitourin Cancer Date: 2018-10-27 Impact factor: 2.872
Authors: Matthew D Grimes; Michael L Blute; Tyler A Wittmann; Michael A Mann; Kristin Zorn; Tracy M Downs; Fangfang Shi; David F Jarrard; Sara L Best; Kyle A Richards; Stephen Y Nakada; E Jason Abel Journal: Urology Date: 2016-06-23 Impact factor: 2.649