title: Two-Port Laparoscopic Reconstructive Surgery of the Urinary Tract with Reusable Umbilical System (Hybrid Less): A Proof of Concept Study.
abstract: OBJECTIVE
  We compared perioperative results and complications of reconstructive surgery of the urinary tract performed using a multichannel platform through the umbilicus and one additional 3.5-mm with a cohort of patients simultaneously treated with conventional 4-port laparoscopy.
  
  
  METHODS
  Matched-pair study comparing perioperative outcomes, postoperative visual analogue pain scale (VAPS) and morbidity of 2-port (n = 20) and 4-port (n = 10) laparoscopic reconstructive urological surgery. Preoperative and perioperative data compared included demographics, type of surgery, operative time, blood loss, decrease in serum hemoglobin, operative complications, length of stay and postoperative complications according to Clavien-Dindo classification.
  
  
  RESULTS
  There was no significant difference between groups regarding age, gender, body mass index, American Society of Anesthesiologists score, type of surgery, operative time, operative complications and intraoperative or postoperative transfusion. Estimated blood loss was lower using reduced-port approach. VAPS at postoperative day one was significantly lower for 2-port approach and so was the length of stay. Patient satisfaction with the wound was higher for 2-port surgery. Differences were not observed in number and severity of postoperative complications.
  
  
  CONCLUSIONS
  Urological reconstructive operations can be safely performed using the hybrid laparoendoscopic single-site umbilical approach, resulting in lower blood loss, higher patient satisfaction and lower postoperative pain, which also facilitate earlier hospital discharge, than the same reconstructive procedures performed through multiport conventional laparoscopy.
authors.affiliation: Departamento Clínico, Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Laureate International Universities, Madrid, Spain.
authors.forename: Javier C
authors.initials: JC
authors.lastname: Angulo
authors.forename: Sergio
authors.initials: S
authors.lastname: Pérez
authors.forename: Ana
authors.initials: A
authors.lastname: García-Tello
authors.forename: Cristina
authors.initials: C
authors.lastname: Redondo
authors.forename: Elisa
authors.initials: E
authors.lastname: Meilán
authors.forename: Ignacio
authors.initials: I
authors.lastname: Arance
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D014472:Umbilicus; D014551:Urinary Tract / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*