Hand-assisted laparoscopic versus laparoscopic nephrectomy as outpatient procedures: a prospective randomized study.

Objectives: The aims of this study were to discuss the hand-assisted laparoscopic nephrectomy (HALNo) outpatient procedure and compare it to the transperitoneal laparoscopic nephrectomy (LNo) outpatient procedure.

Materials And Methods: A prospective, randomized study of 30 patients with renal tumor who were recruited between November 2014 and February 2016 was performed. The primary endpoint of the study was length of hospital stay (LOS).

Results: Fifteen patients received HALNo and 15 received LNo, with a male to female ratio of 2:1. The mean age was 60 years for HALNo and 64 years for LNo (p = 0.62). All patients were discharged within 6 h after the operation. The mean ± SD operation time was 65 ± 24 min [95% confidence limits (CL) 51-79] and 69 ± 24 min (95% CL 56-83) for HALNo and LNo, respectively (p = 0.95). The mean time for which patients stayed at the postoperative care unit was 85 ± 53 min (95% CL 44-126) and 91 ± 66 min (95% CL 54-127) for HALNo and LNo, respectively (p = 0.14). The mean LOS was 220 ± 96 min (95% CL 155-284) and 272 ± 80 min (95% CL 224-320) for HALNo and LNo, respectively (p = 0.53).

Conclusion: HALNo, when performed as an outpatient procedure, is safe and feasible for a well-informed, well-educated and well-selected patient group, and is comparable to LNo regarding postoperative LOS.