Preliminary experience with transperitoneal laparoendoscopic single-site radical nephrectomy using a home-made single-port device in China


Authors: B. I. Hai;  M. A. Lu-Lin;  Z. Shu-Dong
Published in: Urol List 2013; 11(1): 35-39

Overview

Objective:
To present our preliminary experience with transperitoneal laparoendoscopic single-site (LESS) radical nephrectomy (RN) using a home-made single-port device in China.

Patients and 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 270.9 (50–900) ml, and hospital stay 10.4 (5–15) days. The mean visual analogue 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 BMI and stage tumor) and has excellent cosmetic results. Although preliminary oncologic outcome isn’t compromised, the long-term evaluation of these patients awaits.

Key words:
renal cell carcinoma, laparoendoscopic single-site surgery, nephrectomy, preliminary experience


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