Laparoscopic Doppler Technology in Laparoscopic Renal Surgery

BACKGROUND AND OBJECTIVES Laparoscopic Doppler technology has previously been reported to help identify vasculature during laparoscopy. Recently, we published our initial experience with this technology during laparoscopic radical nephrectomy, laparoscopic nephroureterectomy, laparoscopic partial nephrectomy, and robotic-assisted laparoscopic pyeloplasty. We now present a prospective, pilot evaluation of the Doppler probe for these procedures. METHODS A laparoscopic Doppler probe was used in the above laparoscopic renal surgeries in 50 patients. Anatomic findings, Doppler survey time, dissection time, operative time, estimated blood loss, changes in management, subjective time saved/utility, technical difficulties, clinical complications, and ease of use were prospectively recorded. RESULTS Mean Doppler survey time was 1.77 minutes. Mean hilar dissection time was 9.25 minutes. Eight accessory vessels were not seen on preoperative imaging in 7 patients (17%). In 3 cases of RALP, Doppler rectified preoperative imaging in detecting a crossing vessel. The probe altered management in 16% of patients, subjectively saved time in 78% of patients, and had 100% concordance with dissection. There were no complications but 2 technical failures. CONCLUSION The probe is quick, safe, easy to use, and has perfect concordance with surgical dissection. Randomized comparison with and without Doppler assistance is necessary to confirm the utility of this technology.