Upper urinary tract laparoendoscopic single-site surgery based on a novel cost-effective reusable platform

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Disposable platforms for laparoendoscopic single-site (LESS) surgery are common.
• Cost remains a significant barrier to the widespread adoption of LESS surgery.

Purpose of the Study:

• To evaluate the feasibility and outcomes of using a completely reusable LESS platform for kidney pathologies.
• To assess the cost-effectiveness and learning curve associated with reusable LESS systems.

Main Methods:

• LESS kidney procedures (nephrectomy, partial nephrectomy, pyeloplasty, cyst ablation) were performed in 29 patients.
• A reusable single-port device (X-Cone) with standard and prebent instruments was utilized.
• Perioperative data, pain scores (VAS), and complications (Clavien grading) were collected.

Main Results:

• Procedures included 18 nephrectomies, 3 partial nephrectomies, 4 pyeloplasties, and 4 cyst ablations.
• Mean operative times ranged from 89 to 110 minutes; hospital stays were 3.1 to 4.9 days.
• Low complication rates (Clavien II in 2 cases) and minimal pain (Mean VAS 1.5-2.13) were observed, with no open conversions.

Conclusions:

• A completely reusable LESS platform is feasible for upper urinary tract procedures, offering favorable functional and cosmetic results.
• Simplified instrument combinations facilitate handling and shorten the learning curve for LESS surgery.
• Reusable materials significantly reduce costs, potentially increasing the adoption of LESS surgery in clinical practice.