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Retroperitoneal laparoscopic single‐site nephroureterectomy: Initial operative experience
Author(s) -
Okegawa Takatsugu,
Itaya Naoshi,
Hara Hidehiko,
Nutahara Kikuo,
Higashihara Eiji
Publication year - 2012
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/j.1758-5910.2012.00146.x
Subject(s) - medicine , upper urinary tract , cuff , nephrectomy , surgery , ureter , laparoscopy , laparoscopic surgery , transitional cell carcinoma , retroperitoneal space , port (circuit theory) , blood loss , visual analogue scale , urinary system , urology , bladder cancer , kidney , cancer , electrical engineering , engineering
Our aim was to describe our early experience with laparoendoscopic single‐site surgery ( LESS ) via the retroperitoneal approach for upper urinary tract tumors. Methods Since A pril 2010, 21 patients with upper urinary tract cell carcinoma were treated by our team: 12 patients have undergone LESS nephroureterectomy and 9 have undergone standard retroperitoneal laparoscopic surgery. In our LESS procedure, we employed a bendable grasper in the non‐dominant hand and a standard straight laparoscopic instrument in the dominant hand. Nephrectomy was performed using procedures similar to those of conventional laparoscopic nephrectomy. In standard laparoscopic nephroureterectomy, the distal ureter and bladder cuff were excised by using the open method. Results All operations using retroperitoneal LESS nephroureterectomy were completed without conversion to standard laparoscopy or open surgery. No intraoperative or acute postoperative complications occurred. We compared the results of the retroperitoneal single‐port laparoscopic surgery group to the standard retroperitoneal laparoscopic surgery group and found that the retroperitoneal LESS nephroureterectomy had significantly less estimated blood loss ( P = 0.034). No significant difference was noted with respect to age, BMI , operation time, time to oral intake, length of hospitalization, and the visual analog pain scale score at discharge ( P > 0.05). Conclusion The initial reports of retroperitoneal LESS nephroureterectomy demonstrate that the technique is a safe and feasible procedure for upper urinary tract urothelial carcinoma.