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Laparoendoscopic single site reconstructive procedures in urology: medium term results
Rakesh Khanna1, Wahib Isac, Humberto Laydner
1Department of Urology, SUNY Upstate Medical University, Syracuse, New York, USA. khannara@upstate.edu
The Journal of Urology
|March 20, 2012
Summary
Laparoendoscopic single site reconstructive urological surgery shows promising intermediate-term outcomes. Further research is needed to confirm long-term durability and compare it to standard minimally invasive techniques.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Previous studies on laparoendoscopic single site surgery (LESS) have small cohorts and short follow-up.
- There is a need for data on intermediate-term outcomes of reconstructive LESS procedures.
Purpose of the Study:
- To report intermediate-term outcomes of reconstructive laparoendoscopic single site procedures.
- To evaluate clinical and radiographic success in patients undergoing LESS reconstructive surgery.
Main Methods:
- Review of a prospectively maintained database of 185 LESS cases.
- Identification of 32 reconstructive procedures: pyeloplasty, ileal interposition, ureteroneocystostomy, and retrocaval ureter repair.
- Analysis of perioperative data and clinical/radiographic success.
Main Results:
- Median follow-up ranged from 20 to 35 months across procedure types.
- High rates of asymptomatic or improved status reported: 24/25 pyeloplasty, 2/3 ileal interposition, 3/3 ureteroneocystostomy, 1/1 retrocaval ureter repair.
- One delayed incisional hernia repair and one unrelated death occurred; no other major complications.
Conclusions:
- Intermediate-term results for reconstructive LESS are promising.
- Longer follow-up is necessary to confirm the durability of these outcomes.
- Prospective studies are needed to compare LESS with standard minimally invasive approaches.