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Single Port Donor Nephrectomy
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Laparoendoscopic single-site partial nephrectomy without ischemia.

Luca Cindolo1, Francesco Berardinelli, Stefano Gidaro

  • 1Urology Unit, S Pio da Pietrelcina Hospital, Vasto, CH, Italy. lucacindolo@virgilio.it

Journal of Endourology
|October 23, 2010
PubMed
Summary
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This study shows that Laparoendoscopic single-site surgery (LESS) unclamp-nephron-sparing surgery (NSS) is a feasible technique for small renal masses. Patients experienced minimal pain and high satisfaction, with outcomes comparable to standard NSS.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Oncology

Background:

  • Nephron-sparing surgery (NSS) is crucial for managing small renal masses, offering excellent oncologic and functional results.
  • Laparoendoscopic single-site surgery (LESS) represents a significant advancement in minimally invasive surgical techniques.

Purpose of the Study:

  • To evaluate the initial surgical experience and feasibility of LESS unclamp-NSS for small renal masses.
  • To assess the outcomes and patient satisfaction associated with this novel surgical approach.

Main Methods:

  • Six patients with small renal masses underwent LESS unclamp-NSS using a multichannel port and specialized instruments.
  • Data collected included operative time, blood loss, pathology, hematologic parameters, pain, scar evaluation, and length of stay.

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  • Surgery was performed under normal renal perfusion without preliminary clamping.
  • Main Results:

    • The mean operative time was 148 minutes, with a mean blood loss of 201 mL for a mean tumor size of 2.1 cm.
    • One conversion to standard laparoscopy was required due to bleeding; one patient experienced a cerebrovascular accident postoperatively.
    • Pathology revealed various diagnoses, including clear-cell carcinoma and benign lesions, with one positive surgical margin. Hemoglobin decreased by 2.7 g/dL, with minimal pain and high patient satisfaction.

    Conclusions:

    • LESS unclamp-NSS is feasible for selected renal masses, yielding outcomes similar to conventional methods and high patient satisfaction.
    • Consideration of additional trocars for hemostasis and retraction is recommended.
    • Further research with larger patient cohorts and longer follow-up is needed to define the definitive role of LESS unclamp-NSS.