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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
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Laparoendoscopic single-site surgery: initial hundred patients.

Mihir M Desai1, Andre K Berger, Ricardo Brandina

  • 1Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44196, USA. desaim1@ccf.org

Urology
|August 1, 2009
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Summary
This summary is machine-generated.

Laparoendoscopic single-site (LESS) surgery is feasible for urologic procedures in 100 patients. With careful patient selection, this minimally invasive approach offers low conversion and complication rates for various applications.

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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.