title: Laparoendoscopic single-site surgeries: A multicenter experience of 469 cases in Japan.
abstract: To report on a multi-institutional series of non-robotic urological laparoendoscopic single-site surgery in Japan.
  
  
  
  Consecutive cases of laparoendoscopic single-site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates.
  
  
  
  Four hundred and sixty-nine cases were included in the analysis. The most common procedure was adrenalectomy (n = 177) and the second most common procedure was radical nephrectomy (n = 143). The procedures also included nephroureterectomy (n = 40), living donor nephrectomy (n = 40), pyeloplasty (n = 30), urachal remnant excision (n = 9), simple nephrectomy (n = 7), radical prostatectomy (n = 6) and others (n = 17). The access sites included umbilicus (n = 248, 53%) and other sites (n = 221, 47%). A transperitoneal approach was used in 385 cases (82%), and retroperitoneal approach in 84 cases (18%). The median operation time of all procedures was 198 min. Conversion to reduced port surgery, conventional laparoscopy, or open surgery was noted in 27 cases (5.8%), 12 cases (2.6%), and two cases (0.4%), respectively, with an overall conversion rate of 8.7%. Intraoperative complications occurred in 10 cases (2.1%). Post-operative complications were noted in 29 cases (6.2%), including five major complications (1.1%). No mortality was recorded in this series.
  
  
  
  Non-robotic laparoendoscopic single-site surgery is technically feasible and safe for various urologic diseases in Japan. Furthermore, urological laparoendoscopic single-site surgery is a promising minimally invasive surgical option that is feasible for experienced urological surgeons in intermediate-volume centers as well as high-volume centers.
authors.affiliation: Department of Urology, Oita University, Oita, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Sato
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.affiliation: Department of Urology, Hiroshima University, Hiroshima, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
authors.affiliation: Department of Urology, Kyorin University, Tokyo, Japan.
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Okegawa
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
authors.affiliation: Department of Urology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Hoshi
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.affiliation: Department of Urology, Hiroshima University, Hiroshima, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Urology, Kyorin University, Tokyo, Japan.
authors.forename: Naoshi
authors.initials: N
authors.lastname: Itaya
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Narita
authors.affiliation: Department of Urology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hanai
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Okubo
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yanishi
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: Department of Urology, Tokai University School of Medicine, Kanagawa, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Terachi
authors.affiliation: Department of Urology, Oita University, Oita, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Mimata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Japan; laparoendoscopic single-site surgery; multi-institutional; urology