title: Laparoendoscopic single-site radical prostatectomy: technique and initial outcomes.
abstract: BACKGROUND
  Laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a challenging urological procedure and needs to be further evaluated. This study was undertaken to illustrate the safety and initial results of pure LESS-RP with conventional available instruments.
  
  
  METHODS
  A prospective clinical database was established in September 2010 to assess the outcome following the introduction of LESS-RP at our institution. By June 2012, six procedures had been performed. The mean patient age was 74.7 (74.0 - 76.0) years. The mean body mass index (BMI) was 23.8 (19.5 - 32.2) kg/m(2). The LESS-RP was preformed through an extra-peritoneal approach using single port access with QudaPort, 0° lens 5 mm flexible tip video-laparoscope and available conventional laparoscopic instruments. Parameters assessed were operative time, estimated blood loss, intra-operative complications, drainage time, postoperative pain score (visual analogue pain scale (VAPS), 0 - 10), pathological results, and postoperative prostate specific antigen (PSA) levels.
  
  
  RESULTS
  LESS-RP was completed for all six cases without additional trocar placement or conversion to standard laparoscopic or open radical prostatectomy. The mean operative times were 252.5 (190.0 - 305.0) minutes, estimated blood loss was 300 (100 - 500 ml). There was no documentable intraoperative complication. The mean wound-drainage time was 5.2 (2.0 - 7.0) days, and the first postoperative day VAPS was 0.8 (0 - 3.0). Final pathological staging was pT2aN0M0 in four cases and pT2cN0M0 in two cases. Surgical margins were negative for all cases. The one-month post-operative PSA was less than 0.02 ng/ml in each case. All patients were continent without pad usage at 1 year postoperatively.
  
  
  CONCLUSIONS
  The technique of pure LESS-RP is feasible and early outcomes are acceptable.
authors.affiliation: Department of Urology, Beijing Hospital of the Ministry of Health, Beijing 100730, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Zhu
authors.forename: Ya-Qun
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Philippe
authors.initials: P
authors.lastname: Grange
authors.forename: Kilian
authors.initials: K
authors.lastname: Walsh
authors.forename: Bin
authors.initials: B
authors.lastname: Jin
authors.forename: Yao-Guang
authors.initials: YG
authors.lastname: Zhang
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Xuan
authors.initials: X
authors.lastname: Wang
authors.forename: Dong
authors.initials: D
authors.lastname: Wei
authors.forename: Ben
authors.initials: B
authors.lastname: Wan
authors.forename: Jian-Ye
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen