title: Left transperitoneal adrenalectomy with a laparoendoscopic single-site surgery combined technique: initial case reports.
abstract: Laparoendoscopic single-site surgery (LESS) is a step toward the development of minimally invasive surgery. It is initially difficult for surgeons with limited experience to perform the surgery. We describe two cases of left adrenalectomy with a LESS combined with the addition of an accessory port. After a 2.5-cm skin incision was made at the level of the paraumbilicus to insert the primary 12-mm trocar for the laparoscope, a 5-mm nonbladed trocar was placed through the skin incision side-by-side with the primary trocar. A second 3-mm nonbladed trocar was then placed along the anterior axillary line; a multichannel trocar was not used as a single port. Both adrenalectomies were completed successfully. In patients with a minor adrenal tumor, a combined technique using LESS and an additional port is easier than LESS alone and may, therefore, be a bridge between the conventional laparoscopic approach and LESS.
authors.affiliation: Department of Urology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Yufu City, Oita 879-5593, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sumino
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakano
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Mori
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomura
authors.forename: Fuminori
authors.initials: F
authors.lastname: Sato
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Mimata