Initial Experience With 50 Laparoendoscopic Single Site Surgeries Using a Homemade, Single Port Device at a Single Center

Jeon, Hwang Gyun; Jeong, Wooju; Oh, Cheol Kyu; Lorenzo, Enrique Ian S.; Ham, Won Sik; Rha, Koon Ho; Han, Woong Kyu

doi:10.1016/j.juro.2010.01.023

Cited by 85 publications

(54 citation statements)

References 15 publications

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“…Recently, Jeon et al report their cumulative experience with 50 patients undergoing LESS using a homemade single-port device [63]. Of the patients, 34 underwent conventional LESS, while 16 underwent robotic LESS, including PN in 11 cases, nephroureterectomy in 3 cases, and simple and radical nephrectomy in 1 case each.…”

Section: Cumulative Seriesmentioning

confidence: 99%

“…As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. Unfortunately, the quality of evidence of all available studies remains low, mostly being small case series [61][62][63] (evidence level 4) or case-control studies from selected centers [64][65][66][67][68][69][70][71] (evidence level 3b). Given the limited amount of data, available reviews are narrative [11,13,14,[29][30][31]78,79] or are based on expert opinions and consensus meetings [1,2,80] (evidence level 4).…”

Section: 4mentioning

confidence: 99%

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Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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LESS Natural orifice transluminal endoscopic surgery NOTES Robotics UrologyPlease visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery. Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology. Evidence acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology. Evidence synthesis: In urology, NOTES has been completed experimentally via transgastric, transvaginal, transcolonic, and transvesical routes. Initial clinical experience has shown that NOTES urologic surgery using currently available instruments is indeed possible. Nevertheless, because of the immaturity of the instrumentation, early cases have demanded high technical virtuosity. LESS can safely and effectively be performed in a variety of urologic settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low, mostly being small case series or casecontrol studies from selected centers. Thus, the only objective benefit of LESS remains the improved cosmetic outcome. Prospective, randomized studies are largely awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technology advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS and NOTES. Conclusions: NOTES is still an investigational approach in urology. LESS has proven to be immediately applicable in the clinical field, being safe and feasible in the hands of experienced laparoscopic surgeons. Development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

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Section: Cumulative Seriesmentioning

confidence: 99%

Section: 4mentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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“…Over 300 LESS procedures are recorded in medical databases. Thirtyseven radical nephrectomies have been performed using this approach [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. We have presented 11 radical nephrectomies, so we think that our cases can serve as a substantial input to data referring to this issue.…”

Section: Discussionmentioning

confidence: 99%

“…We have noted 86 LESS procedures performed due to oncological disease of the kidney, renal cancer or ureter cancer (nephrectomy, nephroureterectomy, or nephron sparing surgery). In 37 surgeries LESS was used as a method to perform radical nephrectomy in the case of renal cell carcinoma [5][6][7][8][9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Do we need a cosmetic effect for radical nephrectomy? Laparoendoscopic single-site surgery would help to answer this question

Chłosta¹,

Drewa²,

Obarzanowski³

et al. 2011

Videosurgery and Other Miniinvasive Techniques

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“…6,7 After first being carried out for kidney resection in 2007, 8 transumbilical LESS has been successfully introduced for various operations on the urinary system, including adrenal pheochromocytoma, 9 and its feasibility and safety have been shown.…”

Section: Introductionmentioning

confidence: 99%

Transumbilical laparoendoscopic single‐site surgery versus conventional laparoscopy for the resection of retroperitoneal paragangliomas

et al. 2015

Int J of Urology

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Objectives: To compare transumbilical laparoendoscopic single-site surgery with conventional laparoscopy for the resection of retroperitoneal paragangliomas. Methods: In the present case-control study, we compared 11 transumbilical laparoendoscopic single-site surgery procedures with 22 conventional laparoscopy procedures carried out to treat retroperitoneal paragangliomas between June 2004 and October 2013 at Peking Union Medical Hospital, Beijing, China. Operative time, estimated intraoperative blood loss, blood transfusions, intraoperative hypertension, intraoperative hypotension, highest intraoperative systolic blood pressure, lowest intraoperative systolic blood pressure, postoperative fatigue time, postoperative systematic inflammation reaction syndrome, 24-h postoperative visual analog scale scores, postoperative hospital stay duration, and postoperative complications were recorded and analyzed. Results: There were no significant differences in patient characteristics. All surgical procedures were successfully completed in both groups. Minor complications occurred in one case in the laparoendoscopic single-site surgery group and in two cases in the conventional laparoscopy group. In the laparoendoscopic single-site surgery group, the operative time was longer than that in the conventional laparoscopy group (P = 0.001). There were no significant differences in terms of intraoperative hypertension, intraoperative hypotension, highest intraoperative systolic blood pressure, lowest intraoperative systolic blood pressure, estimated blood loss, postoperative fatigue time, postoperative hospital stay or systematic inflammation reaction syndrome between the two groups. The 24-h postoperative visual analog scale score was lower in the laparoendoscopic single-site surgery group (P = 0.002). No recurrence or metastases were observed over the duration of the postoperative follow up. Conclusions: In properly selected patients, transumbilical laparoendoscopic single-site surgery is a feasible, safe and effective procedure for the surgical treatment of retroperitoneal paragangliomas.

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Initial Experience With 50 Laparoendoscopic Single Site Surgeries Using a Homemade, Single Port Device at a Single Center

Abstract: Our homemade single port device is cost-effective, provides adequate range of motion and is more flexible in port placement for laparoendoscopic single site surgery than the current multichannel port.

Cited by 85 publications

References 15 publications

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Do we need a cosmetic effect for radical nephrectomy? Laparoendoscopic single-site surgery would help to answer this question

Transumbilical laparoendoscopic single‐site surgery versus conventional laparoscopy for the resection of retroperitoneal paragangliomas

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