BACKGROUND: Laparoendoscopic single-site (LESS) surgery represents a technique to further reduce morbidity and scarring associated with surgery.
We present our preliminary experience with transperitoneal LESS radical nephrectomy (RN) using a home-made single-port device in China.
METHODS: From July 2010 to November 2011, eleven patients with renal tumor not greater than T2 underwent LESS-RN by an experienced laparoscopic surgeon. A home-made single-port device was used through a 5-cm umbilical incision. A combination of standard and articulating laparoscopic instruments was used. The sequence of steps of LESS-RN was similar to transperitoneal laparoscopic RN. Patient characteristics, perioperative variables and postoperative outcomes were recorded and analyzed.
RESULTS: Except for two transperitoneal laparoscopic conversions and one hand-assisted laparoscopic conversion, the other procedures were completed successfully without conversion to open surgery. The mean operative time was 224.5 (155-297) minutes, estimated blood loss was 270.9 (50-900) ml, and hospital stay was 10.4 (5-15) days. The mean visual analog pain scale (VAPS) on the first postoperative day was 4.0/10. Final pathological analysis revealed renal cell carcinoma in all cases with a stage distribution of three T1a, five T1b, and three T2a tumors. With the mean follow-up period of 21.4 (12-28) months, all patients were alive without evidence of tumor recurrence or metastasis, and were satisfied with the appearance of the scars.
CONCLUSION: Transperitoneal LESS-RN using a home-made single-port device is technically feasible and safe in a selected group of patients (low body mass index and stage tumor) and has excellent cosmetic results. Although preliminary oncologic outcome is not compromised, the long-term evaluation of these patients is awaited.
Written by:
Bi H, Ma L, Hou X, Zhang S, Wang G, Zhao L. Are you the author?
Department of Urology, Peking University Third Hospital, Beijing 100191, China.
Reference: Chin Med J (Engl). 2014;127(2):279-83.
doi: 10.3760/cma.j.issn.0366-6999.20130973
PubMed Abstract
PMID: 24438616
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