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Advances in Urology
Volume 2012 (2012), Article ID 148952, 8 pages
doi:10.1155/2012/148952
Advancements in Laparoscopic Partial Nephrectomy: Expanding the Feasibility of Nephron-Sparing
1Division of Urology, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
2Perelman Center for Advanced Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
Received 15 August 2011; Accepted 25 February 2012
Academic Editor: James A. Brown
Copyright © 2012 Eugene J. Pietzak and Thomas J. Guzzo. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Partial nephrectomy (PN) offers equivalent oncologic outcomes to radical nephrectomy (RN) but has greater preservation of renal function and less risk of chronic kidney disease and cardiovascular disease. Laparoscopic PN remains underutilized likely because it is a technically challenging operation with higher rates of perioperative complications compared to open PN and laparoscopic RN. A review of the latest PN literature demonstrates that recent advancements in laparoscopic approaches, imaging modalities, ischemic mitigating strategies, renorrhaphy techniques, and hemostatic agents will likely allow greater utilization of LPN and expand its usage to increasingly more complex tumors.