Laparoendoscopic Single-site Surgery

Initial Hundred Patients

Mihir M. Desai, Andre K. Berger, Ricardo Brandina, Monish Aron, Brian H. Irwin, David Canes, Mahesh R. Desai, Pradeep P. Rao, Rene Sotelo, Robert Stein, Inderbir S. Gill

Research output: Contribution to journalArticle

275 Citations (Scopus)

Abstract

Objectives: To report our initial experience with laparoendoscopic single-site (LESS) surgery in 100 patients in urology. Methods: Between October 2007 and December 2008, we performed LESS urologic procedures in 100 patients for various indications. These included nephrectomy (N = 34; simple 14, radical 3, donor 17), nephroureterectomy (N = 2), partial nephrectomy (N = 6), pyeloplasty (N = 17), transvesical simple prostatectomy (N = 32), and others (N = 9). Data were prospectively collected in a database approved by the Institutional Review Board. All procedures were performed using a novel single-port device (r-Port) and a varying combination of standard and specialized bent/articulating laparoscopic instruments. Robotic assistance was used to perform LESS pyeloplasty (N = 2) and simple prostatectomy (N = 1). In addition to standard perioperative data, we obtained data on postdischarge analgesia requirements, time to complete convalescence, and time to return to work. Results: In the study period, LESS procedures accounted for 15% of all laparoscopic cases by the authors for similar indications. Conversion to standard multiport laparoscopy was necessary in 3 cases, addition of a single 5-mm port was necessary in 3 cases, and conversion to open surgery was necessary in 4 cases. On death occurred following simple prostatectomy in a Jehovah's Witness due to patient refusal to accept transfusion following hemorrhage. Intra- and postoperative complications occurred in 5 and 9 cases, respectively. Mean operative time was 145, 230, 236, and 113 minutes and hospital stay was 2, 2.9, 2, and 3 days for simple nephrectomy, donor nephrectomy, pyeloplasty, and simple prostatectomy, respectively. Conclusions: The LESS surgery is technically feasible for a variety of ablative and reconstructive applications in urology. With proper patient selection, conversion and complications rates are low. Improvement in instrumentation and technology is likely to expand the role of LESS in minimally invasive urology.

Original languageEnglish (US)
Pages (from-to)805-812
Number of pages8
JournalUrology
Volume74
Issue number4
DOIs
StatePublished - Oct 2009
Externally publishedYes

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Prostatectomy
Nephrectomy
Urology
Jehovah's Witnesses
Tissue Donors
Conversion to Open Surgery
Return to Work
Research Ethics Committees
Intraoperative Complications
Robotics
Operative Time
Laparoscopy
Analgesia
Patient Selection
Length of Stay
Databases
Hemorrhage
Technology
Equipment and Supplies

ASJC Scopus subject areas

  • Urology

Cite this

Desai, M. M., Berger, A. K., Brandina, R., Aron, M., Irwin, B. H., Canes, D., ... Gill, I. S. (2009). Laparoendoscopic Single-site Surgery: Initial Hundred Patients. Urology, 74(4), 805-812. https://doi.org/10.1016/j.urology.2009.02.083

Laparoendoscopic Single-site Surgery : Initial Hundred Patients. / Desai, Mihir M.; Berger, Andre K.; Brandina, Ricardo; Aron, Monish; Irwin, Brian H.; Canes, David; Desai, Mahesh R.; Rao, Pradeep P.; Sotelo, Rene; Stein, Robert; Gill, Inderbir S.

In: Urology, Vol. 74, No. 4, 10.2009, p. 805-812.

Research output: Contribution to journalArticle

Desai, MM, Berger, AK, Brandina, R, Aron, M, Irwin, BH, Canes, D, Desai, MR, Rao, PP, Sotelo, R, Stein, R & Gill, IS 2009, 'Laparoendoscopic Single-site Surgery: Initial Hundred Patients', Urology, vol. 74, no. 4, pp. 805-812. https://doi.org/10.1016/j.urology.2009.02.083
Desai MM, Berger AK, Brandina R, Aron M, Irwin BH, Canes D et al. Laparoendoscopic Single-site Surgery: Initial Hundred Patients. Urology. 2009 Oct;74(4):805-812. https://doi.org/10.1016/j.urology.2009.02.083
Desai, Mihir M. ; Berger, Andre K. ; Brandina, Ricardo ; Aron, Monish ; Irwin, Brian H. ; Canes, David ; Desai, Mahesh R. ; Rao, Pradeep P. ; Sotelo, Rene ; Stein, Robert ; Gill, Inderbir S. / Laparoendoscopic Single-site Surgery : Initial Hundred Patients. In: Urology. 2009 ; Vol. 74, No. 4. pp. 805-812.
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AU - Desai, Mihir M.

AU - Berger, Andre K.

AU - Brandina, Ricardo

AU - Aron, Monish

AU - Irwin, Brian H.

AU - Canes, David

AU - Desai, Mahesh R.

AU - Rao, Pradeep P.

AU - Sotelo, Rene

AU - Stein, Robert

AU - Gill, Inderbir S.

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N2 - Objectives: To report our initial experience with laparoendoscopic single-site (LESS) surgery in 100 patients in urology. Methods: Between October 2007 and December 2008, we performed LESS urologic procedures in 100 patients for various indications. These included nephrectomy (N = 34; simple 14, radical 3, donor 17), nephroureterectomy (N = 2), partial nephrectomy (N = 6), pyeloplasty (N = 17), transvesical simple prostatectomy (N = 32), and others (N = 9). Data were prospectively collected in a database approved by the Institutional Review Board. All procedures were performed using a novel single-port device (r-Port) and a varying combination of standard and specialized bent/articulating laparoscopic instruments. Robotic assistance was used to perform LESS pyeloplasty (N = 2) and simple prostatectomy (N = 1). In addition to standard perioperative data, we obtained data on postdischarge analgesia requirements, time to complete convalescence, and time to return to work. Results: In the study period, LESS procedures accounted for 15% of all laparoscopic cases by the authors for similar indications. Conversion to standard multiport laparoscopy was necessary in 3 cases, addition of a single 5-mm port was necessary in 3 cases, and conversion to open surgery was necessary in 4 cases. On death occurred following simple prostatectomy in a Jehovah's Witness due to patient refusal to accept transfusion following hemorrhage. Intra- and postoperative complications occurred in 5 and 9 cases, respectively. Mean operative time was 145, 230, 236, and 113 minutes and hospital stay was 2, 2.9, 2, and 3 days for simple nephrectomy, donor nephrectomy, pyeloplasty, and simple prostatectomy, respectively. Conclusions: The LESS surgery is technically feasible for a variety of ablative and reconstructive applications in urology. With proper patient selection, conversion and complications rates are low. Improvement in instrumentation and technology is likely to expand the role of LESS in minimally invasive urology.

AB - Objectives: To report our initial experience with laparoendoscopic single-site (LESS) surgery in 100 patients in urology. Methods: Between October 2007 and December 2008, we performed LESS urologic procedures in 100 patients for various indications. These included nephrectomy (N = 34; simple 14, radical 3, donor 17), nephroureterectomy (N = 2), partial nephrectomy (N = 6), pyeloplasty (N = 17), transvesical simple prostatectomy (N = 32), and others (N = 9). Data were prospectively collected in a database approved by the Institutional Review Board. All procedures were performed using a novel single-port device (r-Port) and a varying combination of standard and specialized bent/articulating laparoscopic instruments. Robotic assistance was used to perform LESS pyeloplasty (N = 2) and simple prostatectomy (N = 1). In addition to standard perioperative data, we obtained data on postdischarge analgesia requirements, time to complete convalescence, and time to return to work. Results: In the study period, LESS procedures accounted for 15% of all laparoscopic cases by the authors for similar indications. Conversion to standard multiport laparoscopy was necessary in 3 cases, addition of a single 5-mm port was necessary in 3 cases, and conversion to open surgery was necessary in 4 cases. On death occurred following simple prostatectomy in a Jehovah's Witness due to patient refusal to accept transfusion following hemorrhage. Intra- and postoperative complications occurred in 5 and 9 cases, respectively. Mean operative time was 145, 230, 236, and 113 minutes and hospital stay was 2, 2.9, 2, and 3 days for simple nephrectomy, donor nephrectomy, pyeloplasty, and simple prostatectomy, respectively. Conclusions: The LESS surgery is technically feasible for a variety of ablative and reconstructive applications in urology. With proper patient selection, conversion and complications rates are low. Improvement in instrumentation and technology is likely to expand the role of LESS in minimally invasive urology.

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