Laparoendoscopic single-site surgery: initial hundred patients.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Laparoendoscopic single-site (LESS) surgery is an evolving technique in minimally invasive urology.
• Initial experiences with novel single-port devices and articulating instruments are crucial for assessing feasibility and safety.

Purpose of the Study:

• To evaluate the initial experience and outcomes of 100 patients undergoing urologic procedures using LESS surgery.
• To assess the technical feasibility, complication rates, and convalescence associated with LESS surgery in diverse urologic applications.

Main Methods:

• A prospective database was maintained for 100 patients undergoing LESS urologic procedures between October 2007 and December 2008.
• Procedures included nephrectomy, nephroureterectomy, partial nephrectomy, pyeloplasty, and simple prostatectomy, utilizing a novel single-port device (r-Port) and specialized instruments.
• Robotic assistance was employed for specific procedures like pyeloplasty and simple prostatectomy.

Main Results:

• LESS procedures constituted 15% of all laparoscopic cases for similar indications during the study period.
• Conversion to standard laparoscopy or open surgery was required in 3 and 4 cases, respectively; 3 cases needed an additional 5-mm port.
• Intraoperative and postoperative complications occurred in 5 and 9 cases, respectively. Mean operative times and hospital stays varied by procedure type.

Conclusions:

• Laparoendoscopic single-site (LESS) surgery is technically feasible for a range of ablative and reconstructive urologic procedures.
• Appropriate patient selection is key to achieving low conversion and complication rates.
• Advancements in instrumentation and technology are expected to broaden the application of LESS surgery in urology.