title: Extraperitoneal transumbilical laparoendoscopic single-site radical prostatectomy using a homemade single-port device: 20 cases with midterm outcomes.
abstract: OBJECTIVE
  To describe the surgical technique and to report the midterm outcomes of laparoendoscopic single-site radical prostatectomy (LESS-RP) with a homemade single-port device.
  
  
  METHODS
  Between August 2009 and October 2011, 20 LESS-RP procedures were performed in a single center by a high-volume surgeon. The surgical methods are outlined in the paper. Preoperative, perioperative, pathologic, midterm oncological, and functional outcomes data were analyzed.
  
  
  RESULTS
  On average, patients were 66.1 years old, had a mean body mass index of 24.4 kg/m(2), and a mean prostate-specific antigen (PSA) value of 12.2 ng/ml. No conversion was required; however, a single additional 5-mm port was required in one case. The mean operative time was 248 min; mean estimated blood loss was 94 ml. The mean visual analog pain score at day 3 was 1.5 out of 10, and the mean hospital stay was 15.4 day. Pathology showed one focal positive margin (5 %) in a T3a patient, and mean Gleason score was 6.7. There were a total of four Clavien grade 2 complications. The median follow-up was 22.8 month (range 12-36 month). No PSA recurrence was detected during follow-up period; the potency rate after bilateral neurovascular bundle preservation was 60 % (3/5). Complete continence recovery (no pad) was observed in 85 % of the patients at 1 year, in 90 % at 2 years, and in all three patients at 3 years.
  
  
  CONCLUSIONS
  LESS-RP is technically feasible and safe, with excellent cosmesis, low postoperative pain levels, and acceptable midterm oncological, and functional outcomes. Comparative investigation to conventional LRP is needed.
authors.affiliation: Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang Road, Guangzhou, 510120, Guangdong, People's Republic of China.
authors.forename: Chun
authors.initials: C
authors.lastname: Jiang
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.forename: Tianxin
authors.initials: T
authors.lastname: Lin
authors.forename: Kewei
authors.initials: K
authors.lastname: Xu
authors.forename: Jinli
authors.initials: J
authors.lastname: Han
authors.forename: Hai
authors.initials: H
authors.lastname: Huang
authors.forename: Wenlian
authors.initials: W
authors.lastname: Xie
authors.forename: Yousheng
authors.initials: Y
authors.lastname: Yao
authors.forename: Zhenghui
authors.initials: Z
authors.lastname: Guo
authors.forename: Liangkuan
authors.initials: L
authors.lastname: Bi
mesh_terms: D000368:Aged; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011468:Prostatectomy / Q000295:instrumentation*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014472:Umbilicus
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