Technique of laparoscopic-endoscopic single-site surgery radical nephrectomy.
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).


METHODS
Ten patients with body mass index (BMI) < or = 30 underwent LESS-RN for renal tumour by two experienced laparoscopists.


METHODS
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.


METHODS
Patient demographics, operative details, and final pathology were prospectively recorded. Postoperative evaluation of pain and use of analgesic medication were recorded.


CONCLUSIONS
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.
Stolzenburg
Jens-Uwe
JU
Department of Urology, University of Leipzig, Leipzig, Germany.
Kallidonis
Panagiotis
P
Hellawell
Giles
G
Do
Minh
M
Haefner
Tim
T
Dietel
Anja
A
Liatsikos
Evangelos N
EN
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult