Korean J Urol.  2011 Dec;52(12):842-846.

Initial Experience with Retroperitoneal Laparoendoscopic Single-Site Surgery for Upper Urinary Tract Surgery

• Pak CH
• Baik S
• Kim CS

Abstract

PURPOSE
To report our initial clinical experience and perioperative outcomes of retroperitoneal laparoendoscopic single-site surgery (RLESS) for upper urinary tract surgery.
MATERIALS AND METHODS
Between June 2009 and October 2010, we performed RLESS in 23 patients for various indications including radical nephrectomy (n=4), nephroureterectomy (n=2), simple nephrectomy (n=10), and renal cyst ablation (n=7). RLESS was performed with a homemade single-port device with a conventional rigid laparoscopic instrument and laparoscope. The parameters analyzed were age, body mass index, operative time, estimated blood loss, transfusion, time of oral intake, visual analogue pain scale score (VAPS), length of hospital stay, and complications.
RESULTS
One case of simple nephrectomy was converted to open nephrectomy because of severe adhesion and inadequate surgical exposure. RLESS was completed in 23 patients. Mean operative time was 168.7+/-29.2, 227.5+/-50.0, 230.0+/-56.5, and 70.5+/-8.9 minutes for simple nephrectomy, radical nephrectomy, nephroureterectomy, and renal cyst ablation, respectively. Estimated blood loss was 113.0+/-149.8, 170.0+/-156.8, 400.0+/-141.4, and 22.8+/-16.0 ml. The time to oral intake after surgery was 1.4+/-0.5, 1.2+/-0.5, 1.5+/-0.7, and 1.1+/-0.3 days. The mean VAPS score was 1.1+/-0.2, 2.1+/-0.5, 2.0+/-0.5, and 1.0+/-0.0 of 10 (range, 0.8 to 2.6). The hospital stay was 4.6+/-1.5, 3.7+/-0.5, 6.0+/-1.4, and 3.2+/-1.7 days. No major perioperative complications were observed.
CONCLUSIONS
The initial outcomes of our experience suggest that RLESS is a technically feasible and safe procedure for upper urinary tract surgery. Prospective comparative studies with conventional retroperitoneal laparoscopic surgery are needed to confirm the potential benefits of RLESS.

Keyword

Laparoscopy; Minimally invasive surgical procedures; Nephrectomy; Retroperitoneal space

MeSH Terms

Body Mass Index
Humans
Laparoscopes
Laparoscopy
Length of Stay
Nephrectomy
Operative Time
Pain Measurement
Retroperitoneal Space
Surgical Procedures, Minimally Invasive
Urinary Tract

Figure

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  FIG. 1 The homemade single-port device consisted of an Alexis wound retractor and a surgical glove.

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