Laparoendoscopic single-site surgery in urology: a single-center experience

Abstract

Objective To present our experience on the first 100 cases receiving urological laparoendoscopic single-site surgery(LESS).Methods Between Dec.2008 and May 2011,a cohort of 98patients received a total of 100TriPort TM LESS urologic surgeries for various indications,including 2patients undergoing bilateral surgeries.The proceducres included radical nephrectomy(n=24),partial nephrectomy(n=3),simple nephrectomy(n=10),kidney cyst excision(n=21),adrenlectomy(n=12),transvesical simple prostatectomy(n=9),ureterolithotomy(n=6),and others(n=15).The demographics,perioperative outcomes,and follow-up data were prospectively analyzed.Results Of the 100surgeries,87were smoothly completed.A 5mm ancillary trocar was required in 9cases.Conversion to standard laparoscopy and open surgery were needed in 1and 3patients,respectively.The overall complication rate was 15%,with 6%intraoperatively and 9% postoperatively.The complication rate was 5%for the first 50cases and 10%for the second 50cases.The patients were followed up for 9.9± 5.61(ranging 3-24)months.At the latest follow-up,all patients remained clinically healthy with a delightedly hidden scar.No evidence of recurrence or metastasis was detected in patients receiving tumor resection.Conclusion The LESS is safe and technically feasible for urological surgery,with minimal invasiveness and better cosmesis.Emphasis should be made on patient selection and indication criteria.Improvement in instrumentation,accumulation of clinical practice,and well-designed multicenter prospective clinical trials will promote the use of LESS surgery for treatment of urologic diseases.