title: Renal and Adrenal Minilaparoscopy: A Prospective Multicentric Study.
abstract: OBJECTIVE
  To investigate the role of contemporary minilaparoscopy (ML; 3 mm instruments and laparoscope) and to identify predictive factors for complications in a prospective multicenter series for renal and adrenal surgeries.
  
  
  METHODS
  From July 2013 to December 2014, 110 patients from 6 laparoscopic Spanish centers were enrolled. A common database was used and data were collected in a prospective manner. Standard approach was defined as 3 to 4 3-mm trocars with a 3-mm laparoscope and 3-mm instruments (Karl Storz, Tuttlingen, Germany). Descriptive variables were analyzed and statistical analysis was performed for predictive factors for complications.
  
  
  RESULTS
  Patient mean age was 57.8 ± 14.6 years, with an average body mass index of 25.3 ± 3.6 kg/m(2). Median American Society of Anesthesiologists score was II and 32% (n = 35) of the patients had a previous surgery. A total of 59 nephrectomies, 20 partial nephrectomies, 9 nephroureterectomies, 13 pyeloplasties, 3 pyelolithotomies, and 6 adrenalectomies were performed. Overall operative time was 180 ± 64 minutes. There were 12 clampless partials and 8 with a mean warm ischemia time of 14 ± 7 min. There were 5% of intraoperative and 8% of postoperative complications (Clavien II-IV). Mean hospital stay was 5 ± 2.3 days, with optimal pain and cosmetic control.
  
  
  CONCLUSIONS
  To our knowledge, this is one of the largest prospective series of ML for renal and adrenal surgeries. Despite a mean operative time possibly longer than in standard laparoscopy, clinical and safety outcomes are not compromised. Furthermore, ML results in excellent pain control and cosmetic outcomes.
authors.affiliation: Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain. Electronic address: albbred@hotmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Breda
authors.affiliation: Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellan
authors.affiliation: Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Rui Azevedo
authors.initials: RA
authors.lastname: Freitas
authors.affiliation: Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Ivan
authors.initials: I
authors.lastname: Schwartzmann
authors.affiliation: Department of Urology, Hospital Puerta del Mar, Cádiz, Spain.
authors.forename: Jesus Luis
authors.initials: JL
authors.lastname: Álvarez Osorio
authors.affiliation: Department of Urology, Hospital Rio Hortega, Valladolid, Spain.
authors.forename: Josè Heriberto
authors.initials: JH
authors.lastname: Amón-Sesmero
authors.affiliation: Department of Urology, Hospital General de Vic, Barcelona, Spain.
authors.forename: Josè Antonio
authors.initials: JA
authors.lastname: Bellido
authors.affiliation: Department of Urology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Ramos
authors.affiliation: Department of Urology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Rengifo
authors.affiliation: Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Peña
authors.affiliation: Department of Urology, Fundació Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain.
authors.forename: Humberto
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D000293:Adolescent; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult