Intact Specimen Extraction During Renal Laparoscopy: Muscle-Splitting versus Muscle-Cutting Incision

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Abstract
To determine whether a muscle-splitting extraction incision decreases patient morbidity after renal laparoscopic surgery. Twenty-one patients undergoing laparoscopic simple nephrectomy, radical nephrectomy, or nephroureterectomy had intact specimen extraction through a muscle-splitting incision. The operative and recovery data of these patients were retrospectively compared with those of a matched cohort of 21 patients who underwent specimen extraction through a muscle-cutting incision. With the exception of a greater percentage of male patients in the muscle-cutting group (86% v 52%), there were no statistically significant differences between the two groups. In the muscle-splitting and muscle-cutting groups, there was no significant differences in regard to analgesic use (9.0 +/- 6.6 mg of morphine sulfate equivalent v 7.9 +/- 4.9; P < 0.51), hospital stay (31.2 hours v 30 hours; P < 0.79), recovery (6.7 +/- 4.7 days v 5.7 +/- 4.7 days; P < 0.38), or convalescence (4.2 +/- 2.2 weeks v 4.1 +/- 2.0 weeks; P < 0.90). A muscle-splitting incision for intact renal specimen extraction does not necessarily decrease postoperative morbidity compared with a muscle-cutting extraction.