Laparoendoscopic Single-Site Pyeloplasty Using Additional 2 mm Instruments: A Comparison with Conventional...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Laparoendoscopic single-site surgery (LESS) offers cosmetic and potential recovery benefits.
• Suturing remains a technical challenge in LESS procedures, particularly for pyeloplasty (LESS-P).
• Conventional laparoscopic pyeloplasty (CL-P) is an established minimally invasive approach.

Purpose of the Study:

• To evaluate the feasibility and safety of LESS pyeloplasty (LESS-P) utilizing additional needlescopic instruments.
• To compare the outcomes of LESS-P with conventional laparoscopic pyeloplasty (CL-P).

Main Methods:

• A retrospective matched cohort study comparing 9 LESS-P patients with 18 CL-P patients.
• LESS-P involved a single 2 cm umbilical incision with a homemade port and 2 mm needlescopic instruments for suturing and stenting.
• CL-P served as the control group, with standard laparoscopic access.

Main Results:

• No significant differences in length of stay, blood loss, analgesic requirements, or complications between LESS-P and CL-P.
• LESS-P demonstrated a significantly shorter operative time (252.2 vs. 309.7 minutes, p=0.044).
• Patients undergoing LESS-P reported less postoperative pain on day one (NRS 3.7 vs. 5.6, p=0.024) with a 100% success rate.

Conclusions:

• LESS pyeloplasty (LESS-P) using additional needlescopic instruments is a safe and feasible alternative to CL-P.
• The use of supplementary 2 mm instruments effectively addresses the technical difficulties of suturing in LESS procedures.
• LESS-P shows promise for improved patient outcomes, including reduced operative time and pain.