'Stepped procedure' in laparoscopic cyst decortication during the learning period of laparoscopic surgery: Detailed evaluation of initial experiences

• Published in: Journal of minimal access surgery Vol. 6; no. 2; pp. 37 - 41
• Main Authors: Emre, Huri, Turgay, Akgül, Ali, Ayyıldız, Murat, Bağcıoğlu, Özgür, Yücel, Cankon, Germiyanoğlu
• Format: Journal Article
• Language: English
• Published: India Medknow Publications 01-04-2010; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Care and treatment; Cysts; Diagnosis; Dissection; Health aspects; Laparoscopic surgery; Laparoscopy; Laparoscopy, renal cyst, stepped procedure; Original; Patient outcomes; Polycystic kidney disease; renal cyst; stepped procedure; United States; Laparoscopy; renal cyst; stepped procedure
• ISSN: 0972-9941; 1998-3921
• DOI: 10.4103/0972-9941.65162

Background: We evaluated the importance and efficacy of 'stepped
procedure' in laparoscopic cyst decortication as an initial experience
in it. Materials and Methods: A 36 renal cyst cases were included. The
stepped retroperitonoscopic cyst excision divided into three groups.
First step, doing the incisions to place the ports and expanding the
retroperitoneal space with balloon distension, second step, placement
of trocars and reach to the cyst, third step, aspiration and
decortication of the cyst. The difficulty of the sessions was measured
with the Visual Analog Scale (VAS) scoring system. Score was determined
according to the difficulty of the surgical step ranging from '0' to
'10', '0', too easy, '10' too difficult'. The durations were measured.
One-way ANOVA test was used for statistical analysis. Results: The
mean age was 52.0 (20-75) years. The mean operation time was 52.0 min.
The mean duration of the first step was 12.5, second, 26.0 and third,
22.5 min. The mean VAS of first step, 3.2, second, 6.0 and third, 3.6
There were only significant differences in duration time and VAS score
for second step among the surgeons (P< 0.05). Conclusions:
Laparoscopic cyst decortication may provide gaining experience to
approach the kidney laparoscopically. The side, size and localization
of cysts were not found associated with the difficulty of the method.