title: Small bowel injury during laparoendoscopic single-site surgery for simple nephrectomy.
abstract: OBJECTIVE
  A 71-year-old man underwent a right simple nephrectomy via the laparoendoscopic single-site surgery (LESS) approach for intractable right flank pain and gross hematuria. A postoperative diagnosis of duodenal injury was suspected by physical findings and confirmed by computed tomography imaging.
  
  
  METHODS
  Emergency exploratory laparotomy revealed a <5-mm full-thickness perforation of the duodenum and an accompanying 1-cm seromuscular injury.
  
  
  RESULTS
  The subsequent postoperative course was unremarkable except for a right intraabdominal seroma that resolved without intervention.
  
  
  CONCLUSIONS
  LESS nephrectomy is an effective surgical approach, but more data are needed regarding its surgical outcomes and complications. This case shows that the LESS approach is not without the risk of life-threatening complications, and it must be performed by experienced surgeons in select patients who are notably interested in improved cosmesis, after an informed consent that includes the potential for complications.
authors.affiliation: Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Shreyas S
authors.initials: SS
authors.lastname: Joshi
authors.forename: Chandru P
authors.initials: CP
authors.lastname: Sundaram
mesh_terms: D000368:Aged; D004386:Duodenum / Q000293:injuries*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D021501:Flank Pain / Q000601:surgery; D006417:Hematuria / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D010533:Peritoneal Lavage; D014057:Tomography, X-Ray Computed