To explore the feasibility of segmenting benign bulk specimens in vivo and then removing them from a minimally invasive incision without extending the incision during retroperitoneoscopic surgery for upper urinary tract diseases in Urology.

Patients with adrenal benign lesions, non-functional kidney (not caused by tumor or tuberculosis) and renal hamartoma requiring laparoscopic resection of the lesions were selected from January 2023 to December 2024, and a total of 15 patients were included in the study. The dorsal incision was selected as the sample extraction channel. After the dorsal skin incision, Hasson technique was used to establish the retroperitoneal cavity and place the cannula. The adrenal, renal hamartoma and nonfunctional renal lesions were removed according to the routine surgical procedures. In the process of specimen extraction, the specimen is first placed into the "minimally invasive surgery special excision tissue extraction device" (referred to as the bag), and the specimen is processed in sections in the bag. Different extraction strategies were adopted according to the texture of the specimens without extending the incision. The extraction time of specimens was compared and analyzed.

In all cases, specimens were successfully extracted through laparoscopic minimally invasive incision without extending the incision. The success rate of specimen removal through minimally invasive incisions is 100%. Ranked by the time of specimen removal, they were renal hamartoma [9.52 (8.35-10.69) min], adrenal medullary lipoma [9.78 (8.92-10.91) min], adrenal adenoma [15.12 (12.15-17.52) min], multiple nodular hyperplasia of the adrenal gland [15.27 (14.95-15.59) min], and non-functional kidney [23.31 (21.87-24.57) min]. The postoperative follow-up period was 9 to 12 months. No incision bleeding, infection or incisional hernia occurred in all cases. The extraction time of the specimen is related to the volume of the specimen on the one hand, and the texture of the specimen on the other hand. The extraction time of adrenal medullary lipoma and renal hamartoma was the shortest, and the extraction time of adrenal adenoma and adrenal nodular hyperplasia was the middle. The extraction time of non-functioning kidney specimens is the longest.

Benign bulk specimens of the upper urinary tract can be successfully removed through a minimally invasive laparoscopic incision without the need to extend the incision after in vivo segmentation. This method is convenient and feasible and worthy of clinical promotion.