title: Laparoendoscopic single-site pyelolithotomy with use of a carter-thomason needle grasper.
abstract: OBJECTIVE
  To study the feasibility and safety of the procedure, we present our early experience with laparoendoscopic single-site (LESS) pyelolithotomy performed by use of a Carter-Thomason needle grasper.
  
  
  METHODS
  Four patients underwent LESS pyelolithotomy for the removal of renal pelvic stones. The patients' mean age was 57.8 years, and their mean body mass index was 23.01. We used a homemade single-port device made with a surgical glove that was inserted into a 2.5-cm periumbilical incision. The operation was performed transperitoneally by using a Carter-Thomason grasper. After removal of the stone, a double-J stent was placed in situ, and laparoscopic intracorporeal suturing was performed. No additional ports were used.
  
  
  RESULTS
  All surgeries were completed successfully without conversion to conventional laparoscopy or open surgery. The mean operative time was 124.5 minutes, and the mean estimated blood loss was 255.2 mL. There were no significant complications, except in one patient who required a blood transfusion. The mean duration of hospital stay was 8.3 days. The mean stone size was 3.9 cm. Chemical analysis of the stones showed that three patients had calcium-containing stones and one patient had a uric acid stone. Postoperative radiologic study showed a stone clearance rate of 100%.
  
  
  CONCLUSIONS
  Our results, albeit limited, showed that LESS pyelolithotomy is a feasible and safe procedure. Especially with the use of a Carter-Thomason needle grasper, this operation can be performed without an additional port.
authors.affiliation: Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine & Hospital, Iksan, Korea.
authors.forename: Ill Young
authors.initials: IY
authors.lastname: Seo
authors.forename: Joung Sik
authors.initials: JS
authors.lastname: Rim
keywords: Laparoscopy; Surgical instruments; Urinary calculi