title: Laparoendoscopic single-site retroperitoneoscopic nephrectomy for giant hydronephrosis.
abstract: OBJECTIVE
  To report our experience and assess the feasibility and safety of laparoendoscopic single-site (LESS) retroperitoneoscopic nephrectomy for giant hydronephrosis.
  
  
  METHODS
  Between July 2011 and April 2013, 22 patients underwent LESS retroperitoneoscopic nephrectomy for giant hydronephrosis with nonfunctioning kidneys. A reusable elastic single-port device was inserted through the 2.5-cm incision at the midpoint between the costal arch and iliac crest on the midaxillary line. A rigid, 10-mm, 30° extra-long laparoscope was introduced for monitoring, and a combination of lengthened prebent and conventional laparoscopic instruments was used for handling. The operation procedure was similar to the conventional retroperitoneal laparoscopic nephrectomy.
  
  
  RESULTS
  LESS retroperitoneoscopic nephrectomy was completed in all patients without conversion to open surgery and the additional placement of ports. The mean operative time was 98 minutes (range 77-146), and estimated blood loss was 45 mL (range 20-120). No major intraoperative complications occurred. The postoperative period was uneventful in all patients and the mean hospital stay was 3.4 days (range 2-7).
  
  
  CONCLUSIONS
  LESS retroperitoneoscopic nephrectomy for giant hydronephrosis is technically feasible and safe for selected patients. The combination of conventional and prebent laparoscopic instruments represents an attractive option for retroperitoneoscopic LESS.
authors.affiliation: Department of Urology, Hubei Provincial Corps Hospital , Chinese People's Armed Police Forces, Wuhan, China .
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Wu
authors.forename: Youming
authors.initials: Y
authors.lastname: Xu
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yu
authors.forename: Jiushun
authors.initials: J
authors.lastname: Chen
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
authors.forename: Shaoliang
authors.initials: S
authors.lastname: Wang
authors.forename: Kan
authors.initials: K
authors.lastname: Chen
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D011184:Postoperative Period; D012187:Retroperitoneal Space / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D055815:Young Adult