CU 02. Initial experience of laparoendoscopic single - site simple nephrectomy with new homemade single - port devices and comparative study in a single center

Background: As the development of laparoscopic instruments and techniques, many various laparoendoscopic single-site (LESS) surgery have been performed worldwidely.

Objective: To introduce a new homemade single-port device to perform LESS simple nephrectomy (LESS-SN) and show the comparative study with standard laparoscopic simple nephrectomy (SL-SN).

Methods: We carried out a retrospective study comparing 8 LESS-SN with 13 SL-SN that were performed between March 2007 and August 2011 by a single surgeon. The indications included nonfunctioning kidney and renal tuberculosis. Apart from homemade single-port devices, no special LESS surgical instruments were used. Demographics and clinical outcomes were collected and compared. Additionally, we obtained data on medial cost, first time to flatus and first time to defecation.

Results: All cases were completed eventfully, except that 1 case in SL-SN group needed conversion to open surgery for diaphragmatic injury and hemarrhea. The demographic data of the 2 groups had no significant differences. The mean operative time of two groups were 116.12±39.64 min and 138.07±48.62 min, respectively (P=0.30). Both postoperative stay and gastrointestinal function recovery were similar. Beyond cosmetic advantage, LESS-SN may reduce the blood loss during operation. The postoperative hemoglobin (137.75 vs. 115.70 g/dL) in LESS-SN was statistical more than the SL-SN group (P=0.02). The complication rates were 25% and 23.1%, repectively (P=1.00). stress ulcer (n=1) and hypoproteinemia (n=1) in LESS-SN and pyrexia (n=1), diaphragmatic injury and hemarrhea (n=1), blood loss anemia (n=1) in SL-SN occurred.

Conclusions: Although the operations of LESS-SN were much more difficult, the perioperative outcomes were comparable with standard procedures. The LESS simple nephrectomy with new homemade single-port devices were safe and cost-effective.