Laparoendoscopic Single-Site Pyeloplasty Using Additional 2 mm Instruments: A Comparison with Conventional Laparoscopic Pyeloplasty.
10.4111/kju.2011.52.9.616
- Author:
Sung Ho JU
1
;
Dong Gi LEE
;
Jun Ho LEE
;
Min Ki BAEK
;
Byong Chang JEONG
;
Seong Soo JEON
;
Kyu Sung LEE
;
Deok Hyun HAN
Author Information
1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. deokhyun.han@samsung.com
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Minimally invasive;
Surgical procedure;
Ureteral obstruction
- MeSH:
Analgesics;
Cohort Studies;
Humans;
Laparoscopy;
Length of Stay;
Operative Time;
Stents;
Umbilicus;
Ureter;
Ureteral Obstruction
- From:Korean Journal of Urology
2011;52(9):616-621
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Despite a recent surge in the performance of laparoendoscopic single-site surgery (LESS), concerns remain about performing LESS pyeloplasty (LESS-P) because of the technical difficulty in suturing. We report our techniques and initial experiences with LESS-P using additional needlescopic instruments and compare the results with conventional laparoscopic pyeloplasty (CL-P). MATERIALS AND METHODS: Nine patients undergoing LESS-P were matched 2:1 with regard to age and side of surgery to a previous cohort of 18 patients who underwent CL-P. In both groups, the operating procedures were performed equally except for the number of access points. In the LESS-P group, we made a single 2 cm incision at the umbilicus and used a homemade port. We also used additional 2 mm needlescopic instruments at the subcostal area to facilitate suturing and the ureteral stenting. RESULTS: The preoperative characteristics were comparable in both groups. Postoperatively, no significant differences were noted between the LESS-P and CL-P cases in regard to length of stay, estimated blood loss, analgesics required, and complications. But, LESS-P was associated with a shorter operative time (252.2 vs. 309.7 minutes, p=0.044) and less pain on postoperative day one (numeric rating scale 3.7 vs. 5.6, p=0.024). The success rate was 94% with CL-P (median, 23 months) and 100% with LESS-P (median, 14 months). CONCLUSIONS: Our initial experiences suggest that LESS-P is a feasible and safe procedure. The use of additional 2 mm instruments can help to overcome the difficulties associated with LESS surgery.
