[Technical improvement of transumbilical laparoendoscopic single-site nephrectomy]

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Transumbilical laparoendoscopic single-site nephrectomy (LESS-N) offers cosmetic and minimally invasive benefits.
• Homemade devices can potentially reduce costs and improve accessibility for LESS-N.

Purpose of the Study:

• To evaluate the technical modifications and clinical outcomes of transumbilical LESS-N performed with a homemade device.
• To compare the effectiveness of modified techniques in reducing operative time and improving patient outcomes.

Main Methods:

• Retrospective analysis of 22 transumbilical LESS-N cases (June 2010-April 2013).
• Cases were divided into two groups based on operative date and technique modifications.
• Data collected included operative time, blood loss, complications, and postoperative recovery.

Main Results:

• All procedures were completed successfully without conversion to open surgery.
• Group 2 (utilizing modified techniques) demonstrated a significantly shorter operative time compared to Group 1 (178.9 min vs. 220.6 min, P=0.04).
• No severe postoperative complications or local recurrence were observed during follow-up.

Conclusions:

• Transumbilical LESS-N is a feasible, effective, and safe surgical option.
• Modified techniques, including the single-ring glove and pulling-up techniques, can shorten the learning curve and operative time.
• This approach provides a cosmetically superior, minimally invasive alternative for nephrectomy, particularly for younger or female patients.