719 LAPAROENDOSCOPIC SINGLE-SITE NEPHRECTOMY USING A MODIFIED UMBILICAL INCISION AND A HOMEMADE TRANSUMBILICAL PORT

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy I1 Apr 2010719 LAPAROENDOSCOPIC SINGLE-SITE NEPHRECTOMY USING A MODIFIED UMBILICAL INCISION AND A HOMEMADE TRANSUMBILICAL PORT Won Sik Ham, Ho Song Yu, Won Sik Chang, Woong Kyu Han, Koon Ho Rha, Sang Won Han, Young Deuk Choi, and Sung Joon Hong Won Sik HamWon Sik Ham More articles by this author , Ho Song YuHo Song Yu More articles by this author , Won Sik ChangWon Sik Chang More articles by this author , Woong Kyu HanWoong Kyu Han More articles by this author , Koon Ho RhaKoon Ho Rha More articles by this author , Sang Won HanSang Won Han More articles by this author , Young Deuk ChoiYoung Deuk Choi More articles by this author , and Sung Joon HongSung Joon Hong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1207AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoendoscopic single-site surgery (LESS) has been proposed as an alternative to conventional laparoscopy. To assess the clinical utility of LESS nephrectomy using a modified umbilical incision and homemade transumbilical port in cases requiring extirpative surgery. METHODS Seventeen patients (median age 51 yr, range 0.6-81; median body mass index 22.8, range 14.4-31.2) underwent LESS nephrectomies that were performed by a single surgeon for treatment of benign and malignant conditions. A homemade port was placed through a modified umbilical incision, the length of which had been determined preoperatively. The laparoscopic transperitoneal nephrectomy procedures were performed with various combinations of standard and articulating laparoscopic instruments. Patient characteristics and perioperative outcomes, including pathologic results, were recorded prospectively. RESULTS All 17 extirpative surgeries including simple nephrectomy (seven cases), radical nephrectomy (nine cases), and nephroureterectomy (one case), were completed successfully. The median operation time was 168 min (range 82-220) and the median blood loss was 250 ml (range 0-1050). All specimens were extracted intact through a modified umbilical incision (median length 2.5 cm, range 1.5-6.0). Final pathological analysis revealed a nonfunctioning kidney in five cases, a dysplastic kidney in two cases, a mixed epithelial and stromal tumor in one case, renal cell carcinoma in eight cases (T1: five cases, T3: three cases), and Ta ureter transitional cell carcinoma in one case. Although several technical challenges were experienced, these were overcome by the ambidexterity of the surgeon. CONCLUSIONS LESS nephrectomy using a homemade port and modified umbilical incision is both feasible with minimal incision and cost-effective. Our technique may be more useful for extirpative procedures in which a specimen needs to be removed intact, because incision length can be adjusted freely. Prospective comparisons are warranted to more clearly elucidate the utility of this surgical technique. Seoul, Republic of Korea© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e280 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Won Sik Ham More articles by this author Ho Song Yu More articles by this author Won Sik Chang More articles by this author Woong Kyu Han More articles by this author Koon Ho Rha More articles by this author Sang Won Han More articles by this author Young Deuk Choi More articles by this author Sung Joon Hong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...