Minimally invasive treatment for small kidney cancer?

  1.Propose the concept of early ligation of renal artery in transabdominal laparoscopic radical kidney cancer surgery The principle of tumor-free in radical tumor surgery is the first principle that surgeons must follow. Transabdominal laparoscopic radical kidney cancer surgery has inherent advantages with large operation space and clear anatomical markings. However, because the renal artery is located behind the renal vein, when freeing the renal artery, it is often necessary to fully free the tumor, which is not conducive to the tumor-free principle. We used early dissociation of the renal artery according to the vascular anatomical features, on the right side between the inferior vena cava and the abdominal aorta and on the left side posterior to the Treitz ligament. This is the beginning of the renal artery, with few branches and a fixed position. Once the renal artery is controlled, the superficial renal vein can be easily dissected and thus the tumor can be completely removed. The surgery has the characteristics of tumor-free, blood-free, and clear operative field. We have completed more than 80 cases, and the indexes of operation time, operation bleeding and transit opening are better than traditional methods.  2. Pioneering single-port laparoscopic nephrectomy and renal unit preservation surgery Since Rane et al. first reported single-port laparoscopic nephrectomy at the World Congress of Luminal Urology in 2007, this procedure has rapidly become a new technical highlight in urology. We performed the first such procedure in China in December 2008. At present, we have completed more than 40 cases of various types of single-port laparoscopic surgery, including kidney unit preservation surgery (3 cases) and 8 cases of radical nephrectomy, which is less invasive and has good cosmetic effect, representing a new trend in minimally invasive treatment of kidney cancer, especially NSS surgery.  We are not only the first in China to carry out this type of surgery on a large scale, but also developed our own pre-curved single-hole laparoscopic instruments and single-hole channels, and the relevant research results are being declared as patents. In addition, in order to promote this type of surgery in China, we have summarized a set of cross-operating techniques and designed training models, which are at the leading level at home and abroad.  3. Pioneering research on endoscopic surgery through natural cavity NOTES surgery is a brand new field in the development of minimally invasive surgery, although it is still immature, the advantage of no scar attracts many scholars abroad. A large number of animal experiments are in progress, among which the nephrectomy under NOTES is called “third generation nephrectomy”. We are the first to carry out nephrectomy under NOTES in China, and have completed animal experiments such as transgastric and transcystic kidney biopsy and nephrectomy under hybridization. And at the 30th International Congress of Urology in 2009 (with more than 2000 foreign scholars attending)? Live broadcast of nephrectomy under pure NOTES (animal experiments). This marks that we have reached the world advanced level in this field.