Hand Assisted Transperitoneal versus Retroperitoneal Laparoscopic Nephrectomy (A Comparative Study): Our Experience in Prince Hussein Urology Center

Aim: Hand assisted laparoscopic nephrectomy could be an excellent alternative option to the open approach for benign renal conditions. Besides that, renal malignant processes can be managed by the previous mentioned hand-assisted laparoscopic technique of nephrectomy. In this research the outcomes and the complications of transperitoneal and retroperitoneal approaches of hand assisted laparoscopic nephrectomy were estimated for the differences. Methods: Retrospectively (223) hand assisted laparoscopic nephrectomies (transperitoneal grid iron incision (group1, N= 112) vs. retroperitoneal Pfannenstiel incision (group2, N=111) which were done between September 2022 and June 2024 in Prince Hussein Urology Center were enrolled in this study. Demographic and categorical data of both groups were compared herein. Follow-up period is between 3 and 18 months. Results: Patients’ ages were between (35 and 62 years). There were no differences in patient demographic, and most of categorical data between the both groups. The mean duration of the transperitoneal procedure was significantly shorter than that of the retroperitoneal approach (197.3 and 238.5 minutes, respectively, P < 0.05). While the lower incidence of incisional hernia, blood loss, solid organs impact, and bowel injury were in group2 (P < 0.05). Conclusion: Hand-assisted laparoscopic retroperitoneal nephrectomy is superior to transperitoneal approach in regards to incisional hernia incidence, operative blood loss, and organs injury. Due to the steeper learning in the retroperitoneal approach, the operative period can be equal to or shorter than that of the transperitoneal technique after the surgeons used to and getting more experience in this approach.