Korean J Urol.  2011 Jan;52(1):64-67.

Concomitant Laparoendoscopic Single-Site Surgery for Ureterolithotomy and Contralateral Renal Cyst Marsupialization

• Lee JY
• Lee SW

Abstract

A 63-year-old woman presented with acute right-flank pain and left-flank pain. Computed tomography identified a right ureter stone and a left renal cyst. The patient underwent concomitant laparoendoscopic single-site surgery (LESS) for ureterolithotomy and renal cyst marsupialization with the use of an Alexis(R) wound retractor, which was inserted through the umbilical incision. Flexible laparoscopic instruments and conventional rigid instruments were used during LESS following a procedure similar to that used with conventional laparoscopic surgery without additional transcutaneous ports. LESS may be more efficient at treating bilateral diseases than is conventional laparoscopic surgery.

Keyword

Instrumentation; Kidney diseases, cystic; Laparosocpy; Urinary calculi

MeSH Terms

Female
Humans
Kidney Diseases, Cystic
Laparoscopy
Middle Aged
Ureter
Urinary Calculi

Figure

• 

  FIG. 1 Computed tomography identified a ureter stone in the right kidney (A) and a renal cyst in the left kidney (B). Schematic illustration of laparoendoscopic single-site surgery using a homemade single-port device (C) and a bilateral approach (D) during renal surgery.

• 

  FIG. 2 (A) A 10 mm rigid laparoscope was inserted into the peritoneum through a 12 mm trocar, and the laparoscopic instruments (LaparoAngle®; CambridgeEndo, Framingham, MA, USA) were inserted into the other two trocars. The intraoperative photograph shows the renal cyst (B), which was exposed with the use of LaparoAngle® dissectors (CambridgeEndo), and the suture on the right side of the ureter (C).

Reference

1. Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, et al. Single-port laparoscopic surgery in urology: initial experience. Urology. 2008. 71:3–6.

2. Box G, Averch T, Cadeddu J, Cherullo E, Clayman R, Desai M, et al. Nomenclature of natural orifice translumenal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) procedures in urology. J Endourol. 2008. 22:2575–2581.

3. Lee SY, Kim YT, Park HY, Lee TY, Park SY. Initial experience with laparoendoscopic single-site surgery by use of a homemade transumbilical port in urology. Korean J Urol. 2010. 51:613–618.

4. Jeong CW, Park YH, Shin CS, Kim HH. Synchronous bilateral laparoendoscopic single-site adrenalectomy. J Endourol. 2010. 24:1301–1305.

5. Micali S, Isgrò G, De Stefani S, Pini G, Sighinolfi MC, Bianchi G. Retroperitoneal laparoendoscopic single-site surgery: preliminary experience in kidney and ureteral indications. Eur Urol. 2010. Epub ahead of print.