Advantages Of Ilio-Inguinal Extraction Of The Kidney After Retroperitoneoscopic Nephroureterectomy

Introduction: The manner to extract the specimen after retroperitoneoscopic nephroureterectomy varies to different surgical teams. The aim of the surgeon is to extract the specimen with minimum parietal injuries, according with oncologic principles. The objective of our study was to evaluate the ilio-inguinal approach to extract the specimen after retroperitoneoscopic nephroureterectomy.Material and method: Evaluation and follow-up of 71 patients with retroperitoneoscopic nephroureterectomy for urotelial cancer (65 pelvic urotelial carcinoma and 6 urotelial carcinoma of the ureter). Ilio-inguinal incision was used for 68 patients to extract the specimen.Results: The operating time was 110 +/- 47 min. Blood lost 101 +/- 57 ml. Retroperotoneoscopic approach 10 +/- 4 min. Ilioinguinal approach 25 +/- 10 min. The weight of the specimen was 601 +/- 127g. Tumor dimension was 5,9 +/- 1,9 cm. No conversion to open surgery was made. No late postoperatory complications were registered (postoperatory follow-up at 2 and 6 months).Conclusions: The enlarged nephroureterectomy can be performed using retroperitoneoscopic approach and the specimen can be extracted through an incision at iliac fossa. This approach can be used to extract large specimens preserving the estetic laparoscopic benefit as well as the oncologic safty and reducing the risk of postoperatory eventration.