J J Soble1, I S Gill. 1. Department of Urology, and The Minimally Invasive Surgery Center, The Cleveland Clinic Foundation, Ohio 44195, USA.
Abstract
OBJECTIVES: To report the initial experience with incorporation of needlescopic (2 mm) instruments and optics in various therapeutic minimally invasive urologic procedures. METHODS: Needlescopic techniques were used to successfully perform a variety of urologic surgeries including adrenalectomy, nephrectomy, renal cyst marsupialization, orchiopexy, lymphocele marsupialization, and pelvic lymph node dissection. RESULTS: To date we have performed 42 needlescopic procedures in 39 patients (14 female and 25 male) ranging in age from 8 months to 87 years (mean 46.6 years). Three procedures were converted to conventional laparoscopy and one to open surgery, yielding a needlescopic success rate of 90.5%. Surgical times averaged 132 minutes and blood loss averaged 67 mL. Procedures were performed on an outpatient basis in 33.3% of cases, and 94.9% of patients were discharged home within 23 hours. The overall complication and conversion rate was 14.3% and there was no mortality. CONCLUSIONS: Our initial experience is quite promising. In select patients, needlescopic urologic surgery is feasible and safe, and may reduce postoperative pain, hospital stay, and recovery time, and improve cosmesis. Further evaluation of, and improvement in, 2-mm instrumentation and optical technology is needed.
OBJECTIVES: To report the initial experience with incorporation of needlescopic (2 mm) instruments and optics in various therapeutic minimally invasive urologic procedures. METHODS: Needlescopic techniques were used to successfully perform a variety of urologic surgeries including adrenalectomy, nephrectomy, renal cyst marsupialization, orchiopexy, lymphocele marsupialization, and pelvic lymph node dissection. RESULTS: To date we have performed 42 needlescopic procedures in 39 patients (14 female and 25 male) ranging in age from 8 months to 87 years (mean 46.6 years). Three procedures were converted to conventional laparoscopy and one to open surgery, yielding a needlescopic success rate of 90.5%. Surgical times averaged 132 minutes and blood loss averaged 67 mL. Procedures were performed on an outpatient basis in 33.3% of cases, and 94.9% of patients were discharged home within 23 hours. The overall complication and conversion rate was 14.3% and there was no mortality. CONCLUSIONS: Our initial experience is quite promising. In select patients, needlescopic urologic surgery is feasible and safe, and may reduce postoperative pain, hospital stay, and recovery time, and improve cosmesis. Further evaluation of, and improvement in, 2-mm instrumentation and optical technology is needed.
Authors: Inderbir S Gill; Arnold P Advincula; Monish Aron; Jeffrey Caddedu; David Canes; Paul G Curcillo; Mihir M Desai; John C Evanko; Tomasso Falcone; Victor Fazio; Matthew Gettman; Andrew A Gumbs; Georges-Pascal Haber; Jihad H Kaouk; Fernando Kim; Stephanie A King; Jeffrey Ponsky; Feza Remzi; Homero Rivas; Alexander Rosemurgy; Sharona Ross; Philip Schauer; Rene Sotelo; Jose Speranza; John Sweeney; Julio Teixeira Journal: Surg Endosc Date: 2009-12-09 Impact factor: 4.584
Authors: A N Georgiou; J Rassweiler; T R Herrmann; J U Stolzenburg; E N Liatsikos; Eta Mu Do; P Kallidonis; A de la Teille; R van Velthoven; M Burchardt Journal: World J Urol Date: 2012-07-13 Impact factor: 4.226
Authors: Giovannalberto Pini; Ali Serdar Goezen; Michael Schulze; Marcel Hruza; Jan Klein; Jens Jochen Rassweiler Journal: World J Urol Date: 2011-08-23 Impact factor: 4.226
Authors: Christopher Springer; Antonino Inferrera; Felix Kawan; André Schumann; Paolo Fornara; Francesco Greco Journal: World J Urol Date: 2012-12-16 Impact factor: 4.226