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. 2011 Sep;52(9):616-21.
doi: 10.4111/kju.2011.52.9.616. Epub 2011 Sep 28.

Laparoendoscopic Single-Site Pyeloplasty Using Additional 2 mm Instruments: A Comparison with Conventional Laparoscopic Pyeloplasty

Sung Ho Ju  1 , Dong-Gi Lee, Jun Ho Lee, Min Ki Baek, Byong Chang Jeong, Seong Soo Jeon, Kyu-Sung Lee, Deok Hyun Han
Affiliations

Laparoendoscopic Single-Site Pyeloplasty Using Additional 2 mm Instruments: A Comparison with Conventional Laparoscopic Pyeloplasty

Sung Ho Ju et al. Korean J Urol. 2011 Sep.

Abstract

Purpose: Despite a recent surge in the performance of laparoendoscopic single-site surgery (LESS), concerns remain about performing LESS pyeloplasty (LESS-P) because of the technical difficulty in suturing. We report our techniques and initial experiences with LESS-P using additional needlescopic instruments and compare the results with conventional laparoscopic pyeloplasty (CL-P).

Materials and methods: Nine patients undergoing LESS-P were matched 2:1 with regard to age and side of surgery to a previous cohort of 18 patients who underwent CL-P. In both groups, the operating procedures were performed equally except for the number of access points. In the LESS-P group, we made a single 2 cm incision at the umbilicus and used a homemade port. We also used additional 2 mm needlescopic instruments at the subcostal area to facilitate suturing and the ureteral stenting.

Results: The preoperative characteristics were comparable in both groups. Postoperatively, no significant differences were noted between the LESS-P and CL-P cases in regard to length of stay, estimated blood loss, analgesics required, and complications. But, LESS-P was associated with a shorter operative time (252.2 vs. 309.7 minutes, p=0.044) and less pain on postoperative day one (numeric rating scale 3.7 vs. 5.6, p=0.024). The success rate was 94% with CL-P (median, 23 months) and 100% with LESS-P (median, 14 months).

Conclusions: Our initial experiences suggest that LESS-P is a feasible and safe procedure. The use of additional 2 mm instruments can help to overcome the difficulties associated with LESS surgery.

Keywords: Laparoscopy; Minimally invasive; Surgical procedure; Ureteral obstruction.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIG. 1
FIG. 1
2 mm needlescopic instruments.
FIG. 2
FIG. 2
2 mm needlescopic instruments were inserted to create an environment similar to that of conventional laparoendoscopic surgery.
FIG. 3
FIG. 3
2 mm needlescopic instruments assist with suturing by manipulating tissue, adjusting in needle direction.
FIG. 4
FIG. 4
A photograph of the operation scar: the single skin incision is often hidden within the umbilicus.
See this image and copyright information in PMC

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