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Updated: May 10, 2026
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Single Port Donor Nephrectomy
Published on: March 12, 2011
Small bowel injury during laparoendoscopic single-site surgery for simple nephrectomy
Shreyas S Joshi1, Chandru P Sundaram
1Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA.
Summary
Laparoendoscopic single-site (LESS) nephrectomy is effective but carries risks. A patient experienced a duodenal injury after LESS nephrectomy, highlighting the need for experienced surgeons and informed consent regarding potential complications.
Area of Science:
- Minimally Invasive Surgery
- Urologic Surgery
- Surgical Complications
Background:
- A 71-year-old male presented with intractable right flank pain and gross hematuria.
- The patient underwent a right simple nephrectomy using the laparoendoscopic single-site surgery (LESS) approach.
Observation:
- Postoperative diagnosis of duodenal injury was suspected clinically.
- Confirmed by computed tomography (CT) imaging.
- Emergency exploratory laparotomy revealed a <5-mm full-thickness duodenal perforation and a 1-cm seromuscular injury.
Findings:
- The patient's postoperative course was otherwise unremarkable.
- A right intraabdominal seroma developed, which resolved spontaneously.
- No further interventions were required for the seroma.
Implications:
- Laparoendoscopic single-site (LESS) nephrectomy demonstrates efficacy but requires further study on outcomes.
- This case underscores the potential for severe complications, including life-threatening ones, with the LESS approach.
- LESS procedures necessitate experienced surgeons, careful patient selection, and comprehensive informed consent detailing potential risks.
