Laparoendoscopic Single-Site Surgeries: A Single-Center Experience of 171 Consecutive Cases.
- Author:
Kyung Hwa CHOI
1
;
Won Sik HAM
;
Koon Ho RHA
;
Jae Won LEE
;
Hwang Gyun JEON
;
Francis Raymond ARKONCEL
;
Seung Choul YANG
;
Woong Kyu HAN
Author Information
- Publication Type:Original Article
- Keywords: Kidney; Laparoscopy; Minimally invasive surgical procedures; Robotics; Ureter
- MeSH: Adrenalectomy; Cystectomy; Follow-Up Studies; Gloves, Surgical; Humans; Intraoperative Complications; Kidney; Laparoscopy; Nephrectomy; Operative Time; Orchiectomy; Postoperative Complications; Prospective Studies; Robotics; Surgical Procedures, Minimally Invasive; Ureter; Urologic Diseases
- From:Korean Journal of Urology 2011;52(1):31-38
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: We report our experience to date with 171 patients who underwent laparoendoscopic single-site surgery for diverse urologic diseases in a single institution. MATERIALS AND METHODS: Between December 2008 and August 2010, we performed 171 consecutive laparoendoscopic single-site surgeries. These included simple nephrectomy (n=18; robotic surgeries, n=1), radical nephrectomy (n=26; robotic surgeries, n=2), partial nephrectomy (n=59; robotic surgeries, n=56), nephroureterectomy (n=20; robotic surgeries, n=12), pyeloplasty (n=4), renal cyst decortications (n=22), adrenalectomy (n=4; robotic surgeries, n=2), ureterolithotomy (n=10), partial cystectomy (n=3), ureterectomy (n=1), urachal mass excision (n=1), orchiectomy (n=1), seminal vesiculectomy (n=1), and retroperitoneal mass excision (n=1). All procedures were performed by use of a homemade single-port device with a wound retractor and surgical gloves. A prospective study was performed to evaluate outcomes in 171 cases. RESULTS: Of the 171 patients, 98 underwent conventional laparoendoscopic single-site surgery and 73 underwent robotic laparoendoscopic single-site surgery. Mean patient age was 53 years, mean operative time was 190.8 minutes, and mean estimated blood loss was 204 ml. Intraoperative complications occurred in seven cases (4.1%), and postoperative complications in nine cases (5.3%). There were no complications classified as Grade IIIb or higher (Clavien-Dindo classification for surgical complications). Conversion to mini-incision open surgery occurred in seven (4.1%) cases. Regarding oncologic outcomes, no cancer-related events occurred during follow-up other than one aggressive progression of Ewing sarcoma. CONCLUSIONS: Laparoendoscopic single-site surgery is technically feasible and safe for various urologic diseases; however, surgical experience and long-term follow-up are needed to test the superiority of laparoendoscopic single-site surgery.
