Retroperitoneal laparoendoscopic single-site surgery in urology: initial experience.
OBJECTIVE
To present our initial experience with single-port laparoscopic urologic surgery via the retroperitoneal approach using the Alexis wound retractor with flexible laparoscopic instrumentation.


METHODS
Since December 2008, 14 patients have undergone single-port laparoscopic surgery for various urological diseases, including renal cyst decortication in 5 patients, adrenalectomy in 2 patients, nephroureterectomy in 2 patients, nephrectomy in 3 patients, and ureterolithotomy in 2 patients. For the retroperitoneal approach, the Alexis wound retractor with a single port was used.


RESULTS
All cases were completed without conversion to standard laparoscopic or open surgery. The mean operative time and mean estimated blood loss for decortication of the renal cysts were 56 minutes (range 45-70 minutes) and 179 mL (range 22-398 mL), respectively; the mean operative time and mean estimated blood loss for extirpative or reconstructive surgery were 156 minutes (range 115-21 minutes) and 403 mL (range 35-1324 mL), respectively. The mean hospital stay was 6.5 days (range 4-14 days). There were no major intraoperative complications, but wound dehiscence and bleeding were noted in two patients.


CONCLUSIONS
Retroperitoneal single-port laparoscopic urologic surgery, particularly in patients requiring free-hand suturing, is technically feasible. The initial clinical experience of organ-ablative, extirpative, and reconstructive surgery with this approach is reported.
Ryu
Dong-Soo
DS
Department of Urology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
Park
Woo-Jin
WJ
Oh
Tae-Hee
TH
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*