Two Cases of Kidney Cancer Treated with Hand-assisted Laparoscopic Surgery

Abstract

Laparoscopic nephrectomy was first reported in 1991. It has since been performed widely and has become the standard form of surgery for kidney cancer. Hand-assisted laparoscopic surgery (HALS) is a laparoscopic surgical technique in which the hand of the operator or assistant is inserted through a hand port. HALS can provide the operator with a delicate sense of touch. In our department, HALS was first performed for the treatment of kidney cancer in 2005. Since then, we have experienced 10 more cases. Radical nephrectomy is now usually performed by normal laparoscopic surgery in our department. However, HALS is occasionally performed in living-donor nephrectomy or in atypical cases.
Here, we report two cases of kidney cancer treated with HALS. Normal laparoscopic surgery was considered to be difficult in both cases. Case 1 was a severely obese patient (body mass index : 62.6) and Case 2 had a large tumor. In Case 1, the operator could feel the beating of the renal artery surrounded by abundant fat tissue. In Case 2, traction by the hand was very effective. Both cases were treated without any complications. HALS is well worth considering in such cases.