Single-stage laparoscopic surgery for bilateral organ tumors using a transumbilical approach with a zigzag incision: a report of two cases

Yoichiro Kato,Tomohiko Matsuura,Mitsutaka Onoda,Wataru Obara,Koki Otsuka,Toshimoto Kimura,Misato Takayama,Shigeaki Baba,Daiki Ikarashi,Ryo Takata,Mitsugu Kanehira,Renpei Kato,Jun Sugimura,Akira Sasaki,So Omori

doi:10.1186/s12894-018-0343-6

Yoichiro Kato, Tomohiko Matsuura + Show 13 more

Open Access

https://doi.org/10.1186/s12894-018-0343-6

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Journal: BMC Urology	Publication Date: May 2, 2018
Citations: 1	License type: open-access

Affiliation: Iwate Medical University

Abstract

BackgroundReduced port laparoscopic surgery (RPLS) is comparable to conventional multiport laparoscopic surgery and has the potential to provide improved cosmesis and decreased pain; as such, it satisfies a growing demand for less invasive surgical procedures. Moreover, a zigzag incision of the umbilicus results in a less visible scar in plastic surgery. Here we report a series of two cases with bilateral organ tumors treated by single-stage RPLS using a combination of a transumbilical approach and a zigzag incision.Case presentationCase 1: A 63-year-old man was diagnosed with right renal cell carcinoma (RCC) (clear cell carcinoma, pT1a, venous invasion (−)) and a splenic tumor (cavernous hemangioma). Case 2: An 84-year-old woman was diagnosed with concurrent left RCC (clear cell carcinoma, pT1b, 65 × 65 mm, venous invasion (+)) and ascending colon cancer (adenocarcinoma pT3 with no nodal involvement (0/48)). The perioperative course was uneventful in both cases. However, an additional incision was required in Case 2 for specimen excision. Therefore, the scars were more obvious in Case 2 than in Case 1.ConclusionsAlthough more cases are required to evaluate the superiority of this technique, this novel procedure could be considered for patients with bilateral lesions.

Highlights

Reduced port laparoscopic surgery (RPLS) is comparable to conventional multiport laparoscopic surgery and has the potential to provide improved cosmesis and decreased pain; as such, it satisfies a growing demand for less invasive surgical procedures
Conclusions: more cases are required to evaluate the superiority of this technique, this novel procedure could be considered for patients with bilateral lesions
RPLS must be performed with great care and attention because of the difficulty of manipulating forceps in a small space, such as in nephrectomy [3]

Summary

Introduction

Reduced port laparoscopic surgery (RPLS) is comparable to conventional multiport laparoscopic surgery and has the potential to provide improved cosmesis and decreased pain; as such, it satisfies a growing demand for less invasive surgical procedures. We report a series of two cases with bilateral organ tumors treated by single-stage RPLS using a combination of a transumbilical approach and a zigzag incision. Case presentation: Case 1: A 63-year-old man was diagnosed with right renal cell carcinoma (RCC) (clear cell carcinoma, pT1a, venous invasion (−)) and a splenic tumor (cavernous hemangioma). Case 2: An 84-year-old woman was diagnosed with concurrent left RCC (clear cell carcinoma, pT1b, 65 × 65 mm, venous invasion (+)) and ascending colon cancer (adenocarcinoma pT3 with no nodal involvement (0/48)). Case 1: A 63-year-old man who was diagnosed with a right renal tumor and a splenic tumor presented to our department. He was asymptomatic, but an ultrasonography scan performed during a routine medical examination revealed a right renal mass.

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