Department of Urology, Peking University First Hospital, Institute of
Urology, Peking University, National Urological Cancer Center, Beijing
Objective: To present clinical experience with retroperitoneal
laparoendoscopic single-site surgery(LESS) radical nephrectomy
(RN) using self-made single-port device.
Methods: Between July 2010 and July 2011, a total of 12
patients underwent retroperitoneal LESS radical nephrectomy
by one experienced surgeon, including 5 patients with RCC and
7 patients with upper urinary tract urothelial carcinoma who
also underwent ureterectomy and excision of the bladder cuff.
All procedures were carried within retroperitoneum through an
incision 3 cm above the iliac crest, the length of which was 3 cm
to 4 cm. After extending the retroperitoneum with a ballonet, a
self-made single-port device was placed and surgery procedures
were performed with flexible and standard laparoscopic
instruments. All specimens were extracted intact through the
extended incisions (about 6-8 cm) or a separated incision.
Results: Mean patient age was 70 (56-88), with 3 male patients
and 9 female, and mean patient BMI was 22.4 kg/m2. The mean
estimated blood loss (EBL) was 83 mL (0-400 mL). and the
mean operation time was 94 minutes (60-191 minutes). All
procedures were completed successfully, with no conversion to
standard multiport laparoscopic or open surgery and there were
no intra-operation complications. Postoperative hospital stay
was 7 (5-10) days. One patient (8.3%) was noted to have urinary
tract infection post-operatively.
Conclusions: For proper selected patients, the retroperitoneal
LESS radical nephrectomy is safe and feasible, but observation
for long-term outcome as well as improvements of the
instruments and surgery technique are needed.