Clinical outcomes of laparo-endoscopic single-site surgery radical nephrectomy
The conventional laparoscopic surgery is now paving way to the new technologies including robotic and laparoscopic single-site surgery (LESS). We present our updated experience on LESS radical nephrectomy (LESS–RN). The data from patients undergoing LESS–RN in our two institutions were reviewed along with various clinical and pathological parameters. Between 2008 and 2011, 42 LESS–RN were performed (right = 22, left = 20) with mean (range) age and BMI of 63.7 (33–86) years and 25.1 (18–38.6) kg/m2, respectively. In addition to the instruments in the single port, one extra 3-mm needlescopic instrument was required in 19 patients (right = 17, left = 2). In three patients, two additional 5-mm trocars and instruments were required. None required open conversion. The recorded adverse events include one bowel injury (intraoperative closure without the need for stoma), one postoperative bleeding requiring blood transfusion, one prolonged ileus, and one deep venous thrombosis. The resected specimens revealed pT1a (n = 3), pT1b (n = 33), pT2a (n = 4), and pT3b (n = 2) tumors. The finding of pT3b was incidental rather than planned procedure. None of the patients had positive margins. LESS–RN has proven to be feasible and safe. Beyond cosmesis, further advantages of this approach need to be addressed by randomized trials.