Considerations for safe laparoscopic renal biopsy

  Laparoscopic renal biopsy is known for its reliability in sample collection and safety with low complication risk. In the clinical research conducted at our hospital with the theme of “the Study of renal tissue damage in primary aldosteronism”, the department of urology was in charge of laparoscop...

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Published inJapanese Journal of Endourology and Robotics Vol. 36; no. 1; pp. 124 - 128
Main Authors Kawasaki, Yoshihide, Satake, Yohei, Ono, Yoshikiyo, Katayama, Hiromichi, Miyazaki, Mariko, Satoh, Fumitoshi, Tezuka, Yuta, Shimada, Shuichi, Sato, Takuma, Tanaka, Tetsuhiro, Omata, Kei, Yamazaki, Yuto, Suzuki, Takashi, Yamashita, Shinichi, Morimoto, Ryo, Kawamorita, Naoki, Sasano, Hironobu, Ito, Akihiro
Format Journal Article
LanguageJapanese
Published Japanese Society of Endourology and Robotics 2023
一般社団法人 日本泌尿器内視鏡・ロボティクス学会
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Online AccessGet full text
ISSN2436-875X
DOI10.11302/jserjje.36.1_124

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Abstract   Laparoscopic renal biopsy is known for its reliability in sample collection and safety with low complication risk. In the clinical research conducted at our hospital with the theme of “the Study of renal tissue damage in primary aldosteronism”, the department of urology was in charge of laparoscopic adrenalectomy and laparoscopic renal biopsy. We report on the precautions and safety in the procedure.  Patients with primary aldosteronism with unilateral adrenal involvement enrolled in the clinical study were included. After laparoscopic adrenalectomy, specimens were collected by puncturing the upper pole of the kidney on the affected adrenal gland side three times with an 18 G puncture needle according to the research protocol. Bleeding from the puncture site with or without macroscopic hematuria was controlled endoscopically with forceps until the bleeding ceased.  In a total of 5 cases, sufficient glomeruli were harvested, and none required intervention due to complications. We noted the following of removal of perinephric fat tissue at the planned puncture site, tracking of the puncture needle with an endoscope, assumption of the site when the puncture needle penetrates, traction of the kidney to a position with forceps to puncture easily. A safe laparoscopic renal biopsy was able to be performed, albeit under the special circumstances of the clinical study, by paying attention to several points.
AbstractList   Laparoscopic renal biopsy is known for its reliability in sample collection and safety with low complication risk. In the clinical research conducted at our hospital with the theme of “the Study of renal tissue damage in primary aldosteronism”, the department of urology was in charge of laparoscopic adrenalectomy and laparoscopic renal biopsy. We report on the precautions and safety in the procedure.  Patients with primary aldosteronism with unilateral adrenal involvement enrolled in the clinical study were included. After laparoscopic adrenalectomy, specimens were collected by puncturing the upper pole of the kidney on the affected adrenal gland side three times with an 18 G puncture needle according to the research protocol. Bleeding from the puncture site with or without macroscopic hematuria was controlled endoscopically with forceps until the bleeding ceased.  In a total of 5 cases, sufficient glomeruli were harvested, and none required intervention due to complications. We noted the following of removal of perinephric fat tissue at the planned puncture site, tracking of the puncture needle with an endoscope, assumption of the site when the puncture needle penetrates, traction of the kidney to a position with forceps to puncture easily. A safe laparoscopic renal biopsy was able to be performed, albeit under the special circumstances of the clinical study, by paying attention to several points.  腹腔鏡下腎生検は, 検体採取における確実性や, 少ない合併症リスクが知られている. 「原発性アルドステロン症における腎組織障害の検討」という課題の臨床研究において, 腹腔鏡下腎生検を担当した. 片側副腎病変を伴う原発性アルドステロン症患者を対象に, 腹腔鏡下に患側副腎を摘出後, 研究プロトコールに従い, 患側副腎側の腎臓上極を3回穿刺して検体を採取した. 施行された腹腔鏡下腎生検の確実性と安全性について, 文献的考察を交えて検討した. 施行された計5例で, 十分な糸球体が採取され, 介入を伴う合併症は無かった. 穿刺予定部位の腎周囲脂肪組織の除去, 内視鏡による穿刺針の追従, 刺入角度や貫通した際の部位の想定, 鉗子による穿刺しやすい位置へ腎の移動と固定, 穿刺部の十分な圧迫止血により, 安全な腹腔鏡下腎生検を施行できた.
  Laparoscopic renal biopsy is known for its reliability in sample collection and safety with low complication risk. In the clinical research conducted at our hospital with the theme of “the Study of renal tissue damage in primary aldosteronism”, the department of urology was in charge of laparoscopic adrenalectomy and laparoscopic renal biopsy. We report on the precautions and safety in the procedure.  Patients with primary aldosteronism with unilateral adrenal involvement enrolled in the clinical study were included. After laparoscopic adrenalectomy, specimens were collected by puncturing the upper pole of the kidney on the affected adrenal gland side three times with an 18 G puncture needle according to the research protocol. Bleeding from the puncture site with or without macroscopic hematuria was controlled endoscopically with forceps until the bleeding ceased.  In a total of 5 cases, sufficient glomeruli were harvested, and none required intervention due to complications. We noted the following of removal of perinephric fat tissue at the planned puncture site, tracking of the puncture needle with an endoscope, assumption of the site when the puncture needle penetrates, traction of the kidney to a position with forceps to puncture easily. A safe laparoscopic renal biopsy was able to be performed, albeit under the special circumstances of the clinical study, by paying attention to several points.
Author Ono, Yoshikiyo
Yamashita, Shinichi
Yamazaki, Yuto
Suzuki, Takashi
Sato, Takuma
Ito, Akihiro
Satoh, Fumitoshi
Kawasaki, Yoshihide
Shimada, Shuichi
Kawamorita, Naoki
Satake, Yohei
Miyazaki, Mariko
Tezuka, Yuta
Katayama, Hiromichi
Omata, Kei
Tanaka, Tetsuhiro
Morimoto, Ryo
Sasano, Hironobu
Author_FL 佐竹 洋平
森本 玲
佐藤 琢磨
山下 慎一
小野 美澄
田中 哲洋
手塚 雄太
嶋田 修一
山崎 有人
伊藤 明宏
鈴木 貴
笹野 公伸
方山 博路
尾股 慧
川崎 芳英
川守田 直樹
佐藤 文俊
宮崎 真理子
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DocumentTitleAlternate 腹腔鏡下腎生検における安全性についての検討
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References 12) Mai J, Yong J, Dixson H, et al. (2013) Is bigger better? A retrospective analysis of native renal biopsies with 16 Gauge versus 18 Gauge automatic needles. Nephrology (Carlton) 18 : 525-530
5) Zou G, Chen H, Zhou X, et al. (2022) Retroperitoneal laparoscopic renal biopsy : an 8 year experience at a single centre. Int Urol Nephrol. doi : 10.1007/s11255-022-03324-z
13) Hogan JJ, Mocanu M, Berns JS (2016) The Native Kidney Biopsy : Update and Evidence for Best Practice. Clin J Am Soc Nephrol 11 : 354-362
2) Brazilian Society of U, Silvinato A, Bernardo WM, et al. (2019) Laparoscopic renal biopsy. Rev Assoc Med Bras (1992) 65 : 100-104
10) Bandari J, Fuller TW, Turner capital I UiURM, et al. (2016) Renal biopsy for medical renal disease : indications and contraindications. Can J Urol 23 : 8121-8126
4) Shetye KR, Kavoussi LR, Ramakumar S, et al. (2003) Laparoscopic renal biopsy : a 9-year experience. BJU Int 91 : 817-820
3) Aoun F, Mansour R, Chalouhy C, et al. (2019) Comparing laparoscopic and percutaneous renal biopsy for diagnosing native kidney disease : A matched pair analysis. Prog Urol 29 : 95-100
11) Tondel C, Vikse BE, Bostad L, et al. (2012) Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988-2010. Clin J Am Soc Nephrol 7 : 1591-1597
6) Gupta M, Haluck RS, Yang HC, et al. (2000) Laparoscopic-assisted renal biopsy : an alternative to open approach. Am J Kidney Dis 36 : 636-639
8) Caione P, Micali S, Rinaldi S, et al. (2000) Retroperitoneal laparoscopy for renal biopsy in children. J Urol 164 : 1080-1082
1) Ogata H, Yamazaki Y, Tezuka Y, et al. (2021) Renal Injuries in Primary Aldosteronism : Quantitative Histopathological Analysis of 19 Patients With Primary Adosteronism. Hypertension 78 : 411-421
7) Anas CM, Hattori R, Morita Y, et al. (2008) Efficiency of laparoscopic-assisted renal biopsy. Clin Nephrol 70 : 203-209
9) Ubara Y, Kawaguchi T, Nagasawa T, et al. (2021) Kidney biopsy guidebook 2020 in Japan. Clin Exp Nephrol 25 : 325-364
References_xml – reference: 8) Caione P, Micali S, Rinaldi S, et al. (2000) Retroperitoneal laparoscopy for renal biopsy in children. J Urol 164 : 1080-1082
– reference: 9) Ubara Y, Kawaguchi T, Nagasawa T, et al. (2021) Kidney biopsy guidebook 2020 in Japan. Clin Exp Nephrol 25 : 325-364
– reference: 11) Tondel C, Vikse BE, Bostad L, et al. (2012) Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988-2010. Clin J Am Soc Nephrol 7 : 1591-1597
– reference: 7) Anas CM, Hattori R, Morita Y, et al. (2008) Efficiency of laparoscopic-assisted renal biopsy. Clin Nephrol 70 : 203-209
– reference: 6) Gupta M, Haluck RS, Yang HC, et al. (2000) Laparoscopic-assisted renal biopsy : an alternative to open approach. Am J Kidney Dis 36 : 636-639
– reference: 2) Brazilian Society of U, Silvinato A, Bernardo WM, et al. (2019) Laparoscopic renal biopsy. Rev Assoc Med Bras (1992) 65 : 100-104
– reference: 4) Shetye KR, Kavoussi LR, Ramakumar S, et al. (2003) Laparoscopic renal biopsy : a 9-year experience. BJU Int 91 : 817-820
– reference: 1) Ogata H, Yamazaki Y, Tezuka Y, et al. (2021) Renal Injuries in Primary Aldosteronism : Quantitative Histopathological Analysis of 19 Patients With Primary Adosteronism. Hypertension 78 : 411-421
– reference: 3) Aoun F, Mansour R, Chalouhy C, et al. (2019) Comparing laparoscopic and percutaneous renal biopsy for diagnosing native kidney disease : A matched pair analysis. Prog Urol 29 : 95-100
– reference: 5) Zou G, Chen H, Zhou X, et al. (2022) Retroperitoneal laparoscopic renal biopsy : an 8 year experience at a single centre. Int Urol Nephrol. doi : 10.1007/s11255-022-03324-z
– reference: 12) Mai J, Yong J, Dixson H, et al. (2013) Is bigger better? A retrospective analysis of native renal biopsies with 16 Gauge versus 18 Gauge automatic needles. Nephrology (Carlton) 18 : 525-530
– reference: 10) Bandari J, Fuller TW, Turner capital I UiURM, et al. (2016) Renal biopsy for medical renal disease : indications and contraindications. Can J Urol 23 : 8121-8126
– reference: 13) Hogan JJ, Mocanu M, Berns JS (2016) The Native Kidney Biopsy : Update and Evidence for Best Practice. Clin J Am Soc Nephrol 11 : 354-362
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腹腔鏡下腎生検
Title Considerations for safe laparoscopic renal biopsy
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