V2154 LAPARO-ENDOSCOPIC SINGLE-SITE (LESS) PLUS ONE TROCAR DONOR NEPHRECTOMY USING GELPORT: AN INITIAL CLINICAL EXPERIENCE

Abstract

You have accessJournal of UrologySingle Port Surgery1 Apr 2012V2154 LAPARO-ENDOSCOPIC SINGLE-SITE (LESS) PLUS ONE TROCAR DONOR NEPHRECTOMY USING GELPORT: AN INITIAL CLINICAL EXPERIENCE Takamitsu Inoue, Norihiko Tsuchiya, Shinya Maita, Kazuyuki Numakura, Takashi Obara, Hiroshi Tsuruta, Mitsuru Saito, Shintaro Narita, Yohei Horikawa, Shigeru Satoh, and Tomonori Habuchi Takamitsu InoueTakamitsu Inoue Akita, Japan More articles by this author , Norihiko TsuchiyaNorihiko Tsuchiya Akita, Japan More articles by this author , Shinya MaitaShinya Maita Akita, Japan More articles by this author , Kazuyuki NumakuraKazuyuki Numakura Akita, Japan More articles by this author , Takashi ObaraTakashi Obara Akita, Japan More articles by this author , Hiroshi TsurutaHiroshi Tsuruta Akita, Japan More articles by this author , Mitsuru SaitoMitsuru Saito Akita, Japan More articles by this author , Shintaro NaritaShintaro Narita Akita, Japan More articles by this author , Yohei HorikawaYohei Horikawa Akita, Japan More articles by this author , Shigeru SatohShigeru Satoh Akita, Japan More articles by this author , and Tomonori HabuchiTomonori Habuchi Akita, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2326AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparo-Endoscopic Single-Site (LESS) surgeries can improve cosmesis of renal transplantation donors. However, this procedure requires utilization of the specialized instruments with adversity of the surgical technique which could lead to increased morbidity. We performed a new procedure of LESS plus one trocar donor nephrectomy (LEPODN) in order to use only the standard instruments and achieve good cosmesis. METHODS From October 2010 to August 2011, a total of 15 donors of the living renal transplantation underwent LEPODN. Median age and preoperative creatinine clearance were 59 (26-79) and 110.8 mg/min (73.3-162.2). The GelPort® was loaded at a 5-6 cm para-rectus incision at a level of umbilicus. 12mm camera trocar, 12mm left-hand working trocar and 5mm assistant trocar were placed through the GelPort®. A subcostal 5 mm right-hand working trocar was additionally placed. Graft kidney was extracted by the GelPort® using EndoCatch II® Bag. 19Fr drain was placed at the 5 mm right-hand working trocar. RESULTS The procedure was technically successful. Median operative time, bleeding, and warm ischemic time were 231 minutes (162-285), 25 ml (0-191), and 255 seconds (140-498), respectively. Median one month postoperative serum creatinine concentration of donors and recipients were 0.96 mg/dl (0.5-1.65) and 0.92 (0.50-2.59), respectively. Delayed graft function due to postoperative heart failure was occurred in one patient. CONCLUSIONS LEPODN was technically feasible and can be performed using only the standard instruments with additional subcostal 5 mm right-hand working trocar. LEPODN can be performed by the surgeons with experience of conventional urologic laparoscopic surgery, with minimum morbidity, good graft function and good cosmesis. Conventional LDN LEPODN n 26 15 Number of operator 8 8 Average operation time (min) 249.8 223.6 Average bleeding (ml) 69.3 43.8 Average warm ischemic time (sec) 311.4 277.2 Complication 1(3.8%) 1(6.7%) Open conversion 0(0.0%) 0(0.0%) Blood transfusion 0(0.0%) 0(0.0%) Delayed graft function 0(0.0%) 1(6.7%) © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e869-e870 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takamitsu Inoue Akita, Japan More articles by this author Norihiko Tsuchiya Akita, Japan More articles by this author Shinya Maita Akita, Japan More articles by this author Kazuyuki Numakura Akita, Japan More articles by this author Takashi Obara Akita, Japan More articles by this author Hiroshi Tsuruta Akita, Japan More articles by this author Mitsuru Saito Akita, Japan More articles by this author Shintaro Narita Akita, Japan More articles by this author Yohei Horikawa Akita, Japan More articles by this author Shigeru Satoh Akita, Japan More articles by this author Tomonori Habuchi Akita, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...