Percutaneous ureteral elevation in laparoendoscopic single-site radical nephrectomy.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Laparoendoscopic Single-Site (LESS) radical nephrectomy offers a minimally invasive approach for renal tumor removal.
• Facilitating safe and efficient dissection of the renal hilum is crucial in LESS procedures.
• Standard techniques may present challenges in achieving optimal retraction for hilar control.

Observation:

• A novel suture-assisted ureteral retraction technique was employed during LESS radical nephrectomy.
• A 0-Vicryl suture was percutaneously inserted via a fascial closure device to encircle the ureter and lower pole attachments.
• This facilitated placing the renal vessels on stretch for improved hilar dissection.

Findings:

• The described technique enabled safe and effective dissection and control of the renal hilum.
• The procedure was completed without complications, with minimal blood loss (25 mL) and a total operative time of 265 minutes.
• The patient was discharged on postoperative day 1, with pathology confirming stage pT1b chromophobe renal cell carcinoma and negative margins.

Implications:

• Suture-assisted ureteral retraction is a feasible adjunct for enhancing LESS radical nephrectomy.
• This technique can improve safety and control during renal hilar dissection in select cases.
• Further adoption of this method may expand the applicability of LESS radical nephrectomy.