title: Initial experience with laparoendoscopic single-site simple nephrectomy using the TransEnterix SPIDER surgical system: assessing feasibility and safety.
abstract: OBJECTIVE
  The goal of this report is to describe our initial clinical experience performing a simple nephrectomy with the SPIDER (Single Port Instrument Delivery Extended Reach) laparoendoscopic single-site (LESS) surgical system.
  
  
  METHODS
  One patient with a nonfunctioning kidney secondary to a ureteropelvic junction obstruction underwent a simple nephrectomy through a single incision performed using the SPIDER surgical system. We assessed the technical feasibility, efficiency, and perioperative outcomes.
  
  
  RESULTS
  The SPIDER-LESS nephrectomy was performed successfully without additional skin incisions for laparoscopic ports, instrument clashing, or open conversion. Total operative time was 210 minutes with blood loss of 50  mL. The patient experienced no intraoperative or postoperative complications. Pathologic evaluation confirmed atrophic renal parenchyma.
  
  
  CONCLUSIONS
  The SPIDER surgical system LESS nephrectomy is feasible and safe. Future refinements of the technology and prospective studies are needed to further optimize its application in urology.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, Florida 33136, USA. rleveill@med.miami.edu
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Leveillee
authors.forename: Scott M
authors.initials: SM
authors.lastname: Castle
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gorin
authors.forename: Nelson
authors.initials: N
authors.lastname: Salas
authors.forename: Vladislav
authors.initials: V
authors.lastname: Gorbatiy
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging; D010535:Laparoscopy; D009392:Nephrectomy / Q000009:adverse effects* / Q000295:instrumentation*; D018583:Pliability; D014057:Tomography, X-Ray Computed