title: Laparoendoscopic single-site radical cystectomy and urinary diversion: initial experience in China using a homemade single-port device.
abstract: OBJECTIVE
  We report our initial experience with the first series of laparoendoscopic single-site (LESS) radical cystectomy and urinary diversion performed by a single surgeon using a homemade single-port device at a single institution in China.
  
  
  METHODS
  Between December 2010 and February 2011, we performed five LESS radical cystectomis using a homemade single-port device composed of an inverted cone device of polycarbonate and a powder-free surgical glove. The port was placed into a 5-cm periumbilical incision. The conventional laparoscope and laparoscopic instruments were inserted through the single-port. No additional ports were needed for radical cystoprostatectomy and bilateral standard pelvic lymphadenectomy. Cutaneous ureterostomy and ileal conduit urinary diversion were used for our patients, respectively. Perioperatively, oncologic data and complications were collected and analyzed.
  
  
  RESULTS
  All the procedures were completed successfully. The mean extirpative operative time was 208.2 (168-280) minutes, estimated blood loss was 270 (100-500) mL, bowel recovering time was 9.75 (6-12) days, and postoperative hospital stay was 19.5 (14-28) days. One patient needed a transfusion of 400 mL of red blood cells. The pathologic evaluation revealed negative margins and negative lymph node involvement. After the operations, one patient had a bowel obstruction, while another patient died from cardiac disease. Mean follow-up time was 143 (110-173) days.
  
  
  CONCLUSIONS
  In our experience, LESS radical cystectomy is clinically feasible and safe for selected patients, but requires a learning curve. Our homemade single-port device is a cost-effective and convenient device. Although the initial outcomes have been promising, the long-term oncologic evaluation of these patients awaits.
authors: Department of Urology, Peking University Third Hospital, 49 North Garden Road, Haidian, Beijing, China.
authors: Lu-Lin
authors: LL
authors: Ma
authors: Hai
authors: H
authors: Bi
authors: Xiao-Fei
authors: XF
authors: Hou
authors: Yi
authors: Y
authors: Huang
authors: Guo-Liang
authors: GL
authors: Wang
authors: Lei
authors: L
authors: Zhao
authors: Shu-Dong
authors: SD
authors: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D015653:Cystectomy / Q000295:instrumentation* / Q000379:methods*; D003710:Demography; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D013525:Surgical Instruments; D001743:Urinary Bladder / Q000601:surgery*; D014547:Urinary Diversion / Q000295:instrumentation* / Q000379:methods*