Complications and conversions of upper tract urological laparoendoscopic single-site surgery (less): multicentre experience: results from the NOTES Working Group

Irwin, Brian H.; Cadeddu, Jeffrey A.; Tracy, Chad R.; Kim, F. J.; Molina, Wilson; Rané, Abhay; Sundaram, Chandru P.; Raybourn, James H.; Stein, Robert J.; Gill, Inderbir S.; Kavoussi, Louis R.; Richstone, Lee; Desai, M. M.

doi:10.1590/s1677-55382011000300017

Cited by 7 publications

(7 citation statements)

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“…Furthermore, in the initial stages there may be a higher rate of postoperative complications until such time that the learning curve has reached a plateau. 63 Technical challenges include access, 64 poor triangulation and lack of space leading to instrument clash, 65 which may be overcome by the use of 30° cameras. 22 Instrument control may also be less intuitive.…”

Section: Appraisal Of Evidencementioning

confidence: 99%

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

Siddiqui

Kovzel

Brennan

et al. 2014

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Section: Appraisal Of Evidencementioning

confidence: 99%

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

Siddiqui

Kovzel

Brennan

et al. 2014

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“…In the series of exclusively robotic LESS‐PN, conversion to open surgery via ‘mini‐incision open access’ was reported in two cases (14.3%); however this group did not convert any cases to multiport laparoscopy . This may reflect a difference in baseline comfort with advanced laparoscopy, as all of these robot‐assisted LESS cases were converted directly to an open approach rather than the lower rate of conversion stated in other series of between 0 and 1.5% .…”

Section: Discussionmentioning

confidence: 81%

“…The indication for conversion was a failure to progress effectively via a single-site approach due to intra-abdominal adhesions from prior surgeries necessitating extensive adhesiolysis. Conversion from LESS-PN cohorts to conventional laparoscopy was reported in 6.8-12.5% in large series of urological LESS that focused on assessing complications and conversions [19,20]. This number varies widely due to differing definitions of 'conversion' based on use of accessory ports in LESS cases.…”

Section: Finding Mean (Sd; Range) Duration Follow-up Monthsmentioning

confidence: 99%

Laparoendoscopic single‐site (LESS) partial nephrectomy short‐term outcomes

et al. 2012

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• Laparoendoscopic single-site (LESS) surgery has been used by urologists for a broad range of operations including LESS partial nephrectomy (LESS-PN). To date, experiences of LESS-PN have been presented as small series or as a subset of larger heterogeneous operative experiences, which have shown the overall feasibility and safety of this novel technique.• We report our experience with LESS-PN with complete pathological resection and excellent short-term oncological and renal functional outcomes in the select patient population who underwent this minimally invasive approach. Objective• To present our experience of transumbilical laparoendoscopic single-site (LESS) partial nephrectomy (PN) with pathological and short-term oncological and renal functional outcomes. Patients and Methods• In all, 15 LESS-PNs were performed for cT1a tumours between July 2008 and August 2011 by one surgeon.• All patients underwent transumbilical LESS using a 5-mm flexible-tip laparoscope and a combination of flexible and conventional laparoscopic instruments.• The technique for transperitoneal LESS-PN otherwise replicated conventional laparoscopic PN. • Demographic, perioperative, and postoperative variables were recorded and analysed. Results• Of the 14 patients (eight men), undergoing 15 distinct LESS-PN, the mean (SD) age was 57.9 (8.7) years and the mean (SD, range) tumour size resected was 2.4 (0.8; 1.2-4.0). There were 12 renal cell carcinomas, two angiomyolipomas, and two metanephric adenomas on final pathology, all with negative margins.• The mean (SD) operative duration was 169 (47) min with a mean (SD, range) warm ischaemia time of 14.7 (13.4; 0-37) min; bull-dog clamps were used for hilar-control in nine cases with the remaining six cases done without hilar vascular clamping.• The mean (SD) estimated blood loss in this series was 293 (325) mL (median 200 mL) and no cases required intraoperative or postoperative blood transfusions.• The mean (SD) hospital stay was 2.7 (0.8) days and mean inpatient analgesic requirement in morphine equivalents was 21.7 (11.6) mg.• Follow-up surveillance imaging showed no recurrence at a mean (SD, range) follow-up of 18.3 (12.2; 6-36) months and a negligible change in serum creatinine (<0.1 mg/dL) at a mean (SD, range) follow-up of 17.1 (11.9; 1-36) months. Conclusion• LESS-PN is a feasible and effective operation, providing complete oncological resection along with excellent short-term oncological and renal functional outcomes.

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“…In un recente studio multicentrico (14), l'utilizzo di una porta addizionale è avvenuto nel 23% dei casi, con un tasso di conversione del 20.8% (15.8% a “reduced port laparoscopy”, 4% a laparoscopia e 1% a chirurgia open). La LESS-RN è stata portata a termine in tutti i casi con un tasso di complicanze del 12.1%, del tutto comparabile ai dati di letteratura (13, 14, 17, 18). Il corto follow-up non permette di dare risposte sulla sicurezza oncologica e lo scopo iniziale di questo lavoro era peraltro incentrato sui risultati chirurgici iniziali.…”

Section: Discussioneunclassified

“…Negli ultimi anni molti lavori hanno dimostrato l'efficacia e la sicurezza dell'approccio LESS in ambito urologico (2, 5–19).…”

Section: Introduzioneunclassified

Nefrectomia Radicale Laparoendoscopic Single-site (LESS) nel Tumore Renale: Tecnica e Risultati Chirurgici Cosmetici e Valutazione del Dolore Postoperatorio

et al. 2013

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Complications and conversions of upper tract urological laparoendoscopic single-site surgery (less): multicentre experience: results from the NOTES Working Group

Cited by 7 publications

References 0 publications

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

Laparoendoscopic single‐site (LESS) partial nephrectomy short‐term outcomes

Nefrectomia Radicale Laparoendoscopic Single-site (LESS) nel Tumore Renale: Tecnica e Risultati Chirurgici Cosmetici e Valutazione del Dolore Postoperatorio

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