BACKGROUND: Laparoscopic-endoscopic single-site surgery (LESS) represents the closest surgical technique to scar-free surgery. OBJECTIVE: To assess the feasibility of LESS radical nephrectomy (LESS-RN). DESIGN, SETTING, AND PARTICIPANTS: Ten patients with body mass index (BMI) < or = 30 underwent LESS-RN for renal tumour by two experienced laparoscopists. SURGICAL PROCEDURE: TriPort (Olympus Winter & Ibe, Hamburg, Germany) was inserted through a transumbilical incision. A combination of standard laparoscopic instruments and flexible grasper and scissors was used. A 5-mm 30 degrees camera was also used. The standard laparoscopic transperitoneal nephrectomy technique was performed. MEASUREMENTS: Patient demographics, operative details, and final pathology were prospectively recorded. Postoperative evaluation of pain and use of analgesic medication were recorded. RESULTS AND LIMITATIONS: Ten cases were successfully accomplished (two right-sided tumours and eight left-sided tumours; tumour diameter ranges: 4-8 cm). The mean patient age was 63.5 yr (22-77 yr), and median BMI was 23.56 (18.2-26.6). The mean operative time was 146.4 min (120-180 min), and the mean blood loss was 202 ml (50-900 ml). Pathological examination observed organ-confined T1 renal cell carcinoma in nine cases and pT3b tumour in one case. One bleeding complication occurred. Limitations regarding the intraoperative instrument ergonomics and the requirement for ambidexterity of the surgeon were noted. CONCLUSIONS: LESS-RN proved to be safe and feasible. Further clinical investigation in comparison to the established techniques should take place to evaluate the outcome of LESS-RN.
BACKGROUND: Laparoscopic-endoscopic single-site surgery (LESS) represents the closest surgical technique to scar-free surgery. OBJECTIVE: To assess the feasibility of LESS radical nephrectomy (LESS-RN). DESIGN, SETTING, AND PARTICIPANTS: Ten patients with body mass index (BMI) < or = 30 underwent LESS-RN for renal tumour by two experienced laparoscopists. SURGICAL PROCEDURE: TriPort (Olympus Winter & Ibe, Hamburg, Germany) was inserted through a transumbilical incision. A combination of standard laparoscopic instruments and flexible grasper and scissors was used. A 5-mm 30 degrees camera was also used. The standard laparoscopic transperitoneal nephrectomy technique was performed. MEASUREMENTS: Patient demographics, operative details, and final pathology were prospectively recorded. Postoperative evaluation of pain and use of analgesic medication were recorded. RESULTS AND LIMITATIONS: Ten cases were successfully accomplished (two right-sided tumours and eight left-sided tumours; tumour diameter ranges: 4-8 cm). The mean patient age was 63.5 yr (22-77 yr), and median BMI was 23.56 (18.2-26.6). The mean operative time was 146.4 min (120-180 min), and the mean blood loss was 202 ml (50-900 ml). Pathological examination observed organ-confined T1 renal cell carcinoma in nine cases and pT3b tumour in one case. One bleeding complication occurred. Limitations regarding the intraoperative instrument ergonomics and the requirement for ambidexterity of the surgeon were noted. CONCLUSIONS: LESS-RN proved to be safe and feasible. Further clinical investigation in comparison to the established techniques should take place to evaluate the outcome of LESS-RN.
Authors: Kamran Ahmed; Tim T Wang; Vanash M Patel; Kamal Nagpal; James Clark; Mariam Ali; Samer Deeba; Hutan Ashrafian; Ara Darzi; Thanos Athanasiou; Paraskevas Paraskeva Journal: Surg Endosc Date: 2010-07-10 Impact factor: 4.584
Authors: Rakesh Khanna; Michael A White; Riccardo Autorino; Humberto K Laydner; Wahib Isac; Bo Yang; Fatih Altunrende; Shahab P Hillyer; Gregory Spana; Georges-Pascal Haber; Jihad H Kaouk; Robert J Stein Journal: Curr Urol Rep Date: 2011-04 Impact factor: 3.092
Authors: C Schwentner; T Todenhöfer; J Seibold; S Alloussi; M Germann; S Aufderklamm; J Mischinger; A Stenzl; G Gakis Journal: Urologe A Date: 2013-01 Impact factor: 0.639
Authors: Arkadiusz Miernik; Martin Schoenthaler; Kerstin Lilienthal; Alexander Frankenschmidt; Wojciech Konrad Karcz; Simon Kuesters Journal: Surg Endosc Date: 2012-01-05 Impact factor: 4.584
Authors: Kyung Hwa Choi; Won Sik Ham; Koon Ho Rha; Jae Won Lee; Hwang Gyun Jeon; Francis Raymond P Arkoncel; Seung Choul Yang; Woong Kyu Han Journal: Korean J Urol Date: 2011-01-24