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Related Experiment Video

Updated: Jun 2, 2026

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Published on: March 12, 2011

Laparo-endoscopic single site retroperitoneal partial nephrectomy: a novel concept.

Alejandro R Rodriguez1, Tariq Hakky, Philippe E Spiess

  • 1Department of Urology, Moffitt Cancer Center and Research Institute, FL, USA. armbkdd@yahoo.com

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|April 22, 2011
PubMed
Summary

Laparo-endoscopic single-site (LESS) retroperitoneal partial nephrectomy is a safe and effective minimally invasive option for small kidney masses. This technique offers excellent outcomes with minimal scarring and rapid recovery for selected patients.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Small renal masses are often detected incidentally, requiring treatment decisions between surveillance, partial nephrectomy, and ablative therapies.
  • Partial nephrectomy is a standard treatment, with laparoscopic approaches (pure or robot-assisted) being common in experienced hands.
  • Laparo-endoscopic single-site (LESS) surgery presents a novel, minimally invasive option for well-selected partial nephrectomy cases.

Observation:

  • A 63-year-old male patient with a history of prostate cancer underwent a LESS retroperitoneal partial nephrectomy for a 1.5 cm renal mass.
  • The procedure utilized a Gelpoint device for single-port access, HD flexible endoscope, and articulating instruments.
  • The patient was positioned in the flank, and a 3 cm transverse incision was made below the 12th rib.

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Findings:

  • The LESS retroperitoneal partial nephrectomy was completed in 1 hour with minimal blood loss (5 ml) and a short hospital stay (23 hours).
  • Pathology confirmed a benign hemorrhagic cystic mass.
  • Postoperative pain was well-controlled (VAS 1 at 23 hours), and the patient resumed a regular diet within 16 hours.
  • At one month follow-up, the patient was asymptomatic with minimal scarring.

Implications:

  • LESS retroperitoneal partial nephrectomy is a safe and feasible approach for small, exophytic posterior renal masses.
  • The retroperitoneal approach facilitates access without colon or kidney mobilization.
  • While challenges like instrument clashing exist, the Gelpoint device aids in managing these by maintaining pneumoperitoneum and allowing trocar repositioning.