title: Urologic robot-assisted laparoendoscopic single-site surgery using a homemade single-port device: a single-center experience of 68 cases.
abstract: OBJECTIVE
  To describe our experience with robot-assisted laparoendoscopic single-site (R-LESS) surgeries and evaluate a homemade port system as an effective access technique.
  
  
  METHODS
  Between May 2009 and April 2010, 68 consecutive R- LESS urologic operations were performed in our institution. A 4 to 5 cm long incision was made over the umbilicus. After the inner ring of the Alexis wound retractor was placed into the peritoneum, a common size 7 surgical glove was then applied over the external side of the wound retractor. A homemade single port was established by inserting two 12-mm trocars and two 8-mm trocars through fingers of a surgical glove and securing it to the port.
  
  
  RESULTS
  Sixty-eight patients underwent R-LESS, including partial nephrectomy in 51, nephroureterectomy in 12, radical nephrectomy and adrenalectomy in 2 each, and simple nephrectomy in 1. Mean patient age was 56 years (range 16-81 y). Mean body mass index was 23.9 kg/m(2) (range 17.2-32.9 kg/m(2)). The mean operative time was 219 minutes (range 109-382 min). Mean estimated blood loss 319 mL (range 50-1550 mL), and change in hematocrit was 5.2 % (range 0.0-14.8%). At a mean follow-up of 8 months, there were no port-related complications, and cosmesis was excellent.
  
  
  CONCLUSIONS
  R-LESS is feasible and can be safely applied to a variety of urologic operations, considering the low intraoperative complication rate. Our homemade single-port device provides adequate range of motion and is more flexible in port placement for R-LESS than the current multichannel port.
authors: Department of Urology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jae
authors: J
authors: Won Lee
authors: Francis Raymond P
authors: FR
authors: Arkoncel
authors: Koon Ho
authors: KH
authors: Rha
authors: Kyung Hwa
authors: KH
authors: Choi
authors: Ho Song
authors: HS
authors: Yu
authors: Yunbyung
authors: Y
authors: Chae
authors: Woong Kyu
authors: WK
authors: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007430:Intraoperative Care; D010535:Laparoscopy / Q000295:instrumentation*; D008875:Middle Aged; D009873:Operating Rooms; D011182:Postoperative Care; D012371:Robotics / Q000295:instrumentation*; D013525:Surgical Instruments; D013520:Urologic Surgical Procedures / Q000295:instrumentation*; D055815:Young Adult