Laparoendoscopic Single-Site Urological Surgery Using a Homemade Single Port Device: The First 70 Cases Performed at a Single Center by One Surgeon

Abstract

Laparoendoscopic single-site (LESS) surgery was used to treat various urological operations by a single surgeon who was skilled in conventional laparoscopic surgery. The effectiveness and safety of the procedure were examined. LESS surgery was performed on 70 patients by using a homemade single port device composed of an Alexis® wound retractor and a powder-free surgical glove. There were 29 cases of varicocelectomy (including two bilateral cases), 21 cases of renal cyst marsupialization (including one bilateral case), 16 cases of ureterolithotomy, 3 cases of radical nephrectomy, and 1 case of radical nephroureterectomy. The mean patient age was 42.90 ± 17.58 years (range, 11 to 74 years), and the male-to-female ratio was 55:15. In two cases (one ureterolithotomy and one radical nephrectomy), the LESS surgery was converted to conventional laparoscopic surgery. The mean operative time was 96.02 minutes (range, 30 to 285 minutes), the estimated blood loss was 60.80 mL (range, 0 to 500 mL), and the mean hospital stay was 5.10 days (range, 3 to 15 days). Only one patient had to use patient-controlled anesthesia due to pain; none of the patients developed major complications; and all patients were satisfied, with 85.7% expressing a high degree of satisfaction. In the urological field, LESS surgery using a homemade single-port device appears to be a feasible and safe surgical treatment option that could replace conventional laparoscopic surgery.