Laparo-endoscopic single site (LESS) management of benign kidney diseases: evaluation of complications

To present our experience with Laparo-Endoscopic Single Site (LESS) management of benign kidney diseases.

Between September 2008 and November 2009, 18 patients underwent single port transumbilical laparoscopic surgery for nephrectomy for a nonfunctioning kidney (7 cases), cyst decortications for symptomatic renal cyst (10 cases), and redo-dismembered pyeloplasty with previously failed laparoscopic surgical repair (1 case). Patients underwent surgery through a single 2-cm infraumbilical incision with the triport laparoscopic-port. All pathological reports of LESS nephrectomy and cyst decortications confirmed with chronic pyelonephritis and simple cysts, respectively Histology of xanthogranulomotus pyelonephritis showed two cases of the nephrectomy procedure.

Mean patient age and BMI were 61 +/- SD 14.2 years and 24.75 +/- SD 11.2 kg/m2, respectively Mean operating time was 187.7 +/- SD 71.4 min. LESS was a possible and safe approach in 77.8% of patients. All LESS cyst decortications and redo-pyeloplasty were completed without major complications or conversion to open surgery. However, there was one case each of LESS cyst decortication and pyeloplasty requiring an additional 3-mm port for suturing due to bleeding and an instrument error. For LESS nephrectomy, two (28.6%) with higher waist circumference were converted to standard laparoscopic nephrectomy due to failure to progress. One post operative complication of incisional hernia occurred in a patient with chronic bronchitis and asthma.

LESS for the management of benign kidney diseases is an effective and safe treatment option with selected patients and experienced surgeon.