736 LAPAROENDOSCOPIC SINGLE SITE (LESS) SURGERY: INITIAL 100 PATIENTS

摘要

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy I1 Apr 2010736 LAPAROENDOSCOPIC SINGLE SITE (LESS) SURGERY: INITIAL 100 PATIENTS Mihir M. Desai, Andre Berger, Ricardo Brandina, Monish Aron, Brian Irwin, Mahesh Desai, Pradeep Rao, Rene Sotelo, David Canes, Robert Stein, and Inderbir S. Gill Mihir M. DesaiMihir M. Desai Los Angeles, CA More articles by this author , Andre BergerAndre Berger Los Angeles, CA More articles by this author , Ricardo BrandinaRicardo Brandina Los Angeles, CA More articles by this author , Monish AronMonish Aron Los Angeles, CA More articles by this author , Brian IrwinBrian Irwin Cleveland, OH More articles by this author , Mahesh DesaiMahesh Desai Nadiad, India More articles by this author , Pradeep RaoPradeep Rao Nadiad, India More articles by this author , Rene SoteloRene Sotelo Caracas, Venezuela More articles by this author , David CanesDavid Canes Burlington, MA More articles by this author , Robert SteinRobert Stein Cleveland, OH More articles by this author , and Inderbir S. GillInderbir S. Gill Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1224AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparo-endoscopic single site (LESS) surgery is a novel minimally invasive approach that has recently been used to perform various urologic procedures. To our knowledge, we report our experience with the initial 100 LESS procedures in urology. METHODS Between October 2007 and December 2008, we performed LESS urologic procedures in 100 patients for various indications. These included nephrectomy (N=34; simple 14, radical 3, donor 17), nephroureterectomy (N=2), partial nephrectomy (N=6), pyeloplasty (N=17), transvesical simple prostatectomy (N=32) and others (N=11). All procedures were performed using a novel single port device (r-Port) and a varying combination of standard and specialized bent/articulating laparoscopic instruments. RESULTS In the study period, LESS procedures accounted for 15% of all laparoscopic cases by the authors for similar indications. Conversion to standard multi-port laparoscopy was necessary in 3 cases, addition of a single 5 mm port was necessary in 4 cases, and conversion to open surgery was necessary in 4 cases. There was a mortality following simple prostatectomy in a Jehovah's Witness due to patient refusal to accept transfusion following hemorrhage. Intra- and post-operative complications occurred in 5 and 9 cases, respectively. Mean operative time was 145, 236, 220, and 113 minutes and hospital stay was 2, 2.9, 2, and 3 days for simple nephrectomy, donor nephrectomy, pyeloplasty and simple prostatectomy, respectively. CONCLUSIONS Laparoendoscopic single site (LESS) surgery is technically feasible for a variety of ablative and reconstructive applications in urology. With proper patient selection, conversion and complications rates are low. Improvement in instrumentation and technology is likely to expand the role of LESS in minimally invasive urology. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e288 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mihir M. Desai Los Angeles, CA More articles by this author Andre Berger Los Angeles, CA More articles by this author Ricardo Brandina Los Angeles, CA More articles by this author Monish Aron Los Angeles, CA More articles by this author Brian Irwin Cleveland, OH More articles by this author Mahesh Desai Nadiad, India More articles by this author Pradeep Rao Nadiad, India More articles by this author Rene Sotelo Caracas, Venezuela More articles by this author David Canes Burlington, MA More articles by this author Robert Stein Cleveland, OH More articles by