Laparoendoscopic single-site surgery: early experience with tumor nephrectomy

Area of Science:

• Minimally invasive surgery
• Urologic oncology
• Surgical innovation

Background:

• Laparoendoscopic single-site surgery (LESS) offers a near-scarless approach.
• Evaluating LESS for renal tumor nephrectomy is crucial for advancing minimally invasive techniques.

Purpose of the Study:

• To assess the feasibility and perioperative outcomes of LESS for renal tumor nephrectomy.
• To determine the safety and efficacy of this technique in a selected patient cohort.

Main Methods:

• Eight patients with low BMI underwent single-port nephrectomy using Tri-Ports.
• Standard laparoscopic equipment, a flexible grasper, and a high-definition camera were utilized.
• Data on operative details, complications, pathology, pain, and analgesic use were prospectively recorded.

Main Results:

• All eight LESS nephrectomies were completed successfully without conversion to conventional laparoscopy.
• Median operative duration was 141 minutes with a median blood loss of 103 mL.
• Histology confirmed complete excision of organ-confined T1 renal-cell carcinoma in all patients, with no intraoperative or postoperative complications.

Conclusions:

• LESS nephrectomy is a feasible and safe option for carefully selected patients with low BMI and early-stage renal tumors.
• The use of multi-instrument ports and flexible instruments facilitates LESS nephrectomy.
• Oncologic outcomes were not compromised, but further randomized studies are needed to validate these findings.