Laparo-endoscopic single-site left adrenalectomy using conventional ports and instruments

Bhandarkar, Deepraj S.; Mittal, Gaurav; Katara, Avinash N.; Behera, Ramya Ranjan

doi:10.4103/0974-7796.130660

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…On the issue of what is the preferred equipment for LESS, one can conclude that the spectrum of specialised systems for LESS surgery from different companies is broad [ 7 , 31 ]. We have found in the literature attempts to perform LESS AE with conventional ports and instruments labelled by some authors as “home-made” [ 3 , 12 , 32 , 33 ]. In our view, it is important to choose a system that requires only a short incision.…”

Section: Discussionmentioning

confidence: 99%

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Hora¹,

Ürge²,

Stránský³

et al. 2014

Videosurgery and Other Miniinvasive Techniques

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IntroductionAt our institution, laparoendoscopic single-site surgery (LESS) has been established as a technique for laparoscopic nephrectomy since 2011, and since 2012 in selected cases for adrenalectomy (AE) as well.AimTo compare LESS AE with standard laparoscopic AE (SLAE).Material and methodsBetween 3/2012 and 7/2014, 35 adrenalectomies were performed. In 18 (51.4%), a LESS approach was chosen. Indications were strictly non-complicated cases (body mass index (BMI) < 34 kg/m2, tumour ≤ 7 cm, non-malignant aetiology, no previous surgery). All LESS procedures were done by one surgeon. Standard equipment was a 10 mm rigid 0° camera, Triport+, one pre-bent grasper, and a sealing instrument. The approach was pararectal in all cases except one (transumbilical in a slim man). Three patients with LESS were excluded (2 partial AEs only, one adrenal cancer converted to SLAE and then to open surgery). These 15 LESS AE procedures were compared to 15 SLAEs with similar characteristics chosen among 54 SLAEs performed in the period 1/2008–2/2012.ResultsIn 8 cases (53.3%) of LESS AE, a 3 mm port was added to elevate the liver/spleen. Mean parameters of LESS AE vs. SLAE (Wilcoxon test): maximal tumour diameter 43.7 mm vs. 36.1 mm (p = 0.28), time of surgery 63.3 min vs. 55.3 min (p = 0.22), blood loss 38.0 ml vs. 38.0 ml (p = 0.38), BMI 26.9 kg/m2 vs. 28.5 kg/m2 (p = 0.13), discharge from hospital 5.4 days vs. 3.9 days (p = 0.038). There were no complications in either group.ConclusionsThe LESS AE is feasible in selected cases, especially small left-sided tumours in thin patients with no history of previous abdominal operations, but requires an additional port in half of the cases.

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Section: Discussionmentioning

confidence: 99%

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Hora¹,

Ürge²,

Stránský³

et al. 2014

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…In 2005, Hirano and colleagues [ 9 ] first reported their experience of performing a retroperitoneoscopic adrenalectomy by using a single-port technique, which was demonstrated to be effective and relatively minimally invasive. Since then, laparoendoscopic single-site adrenalectomy (LESS-A) has increasingly gained popularity as a treatment for adrenal lesions [ [10] , [11] , [12] , [13] ].…”

Section: Introductionmentioning

confidence: 99%

Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis

Kang

et al. 2021

Annals of Medicine &Amp; Surgery

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Background To investigate the outcomes of laparoendoscopic single-site adrenalectomy (LESS-A) compared to multi-port laparoendoscopic adrenalectomy (m-LA). Methods Studies comparing LESS-A with m-LA were identified from PubMed, Embase, and Cochrane Library before June 2020. Post-operative pain, resumption outcomes, and perioperative outcomes were analyzed. We conducted meta-analyses using the Mantel-Haenszel method with random-effects model. Subset analyses were conducted according to peritoneal and retroperitoneal approaches. A small study effect was illustrated using funnel plots and Egger's test. Results One randomized controlled trial (RCT) and nineteen retrospective cohort studies involving 1554 patients were included for analyzed. Pooled analysis showed that LESS-A had significantly lower postoperative pain scores (MD −0.77, 95%CI −1.45 to −0.10) and less pain medication used (RR 0.74, 95%CI 0.60 to 0.91) compared to m-LA. Besides, LESS-A had significantly shorter hospital stays (MD −0.75, 95%CI −1.18 to −0.33), shorter duration of oral intake resumption (MD −0.33, 95%CI −0.60 to −0.06), and better cosmetic satisfaction (SMD 1.15, 95%CI 0.21 to −2.09). As for perioperative outcomes, LESS-A led to significant longer operative time (MD 13.43, 95%CI 4.08 to 22.77). No significant differences were observed in terms of the remaining perioperative outcomes. Conclusions LESS-A is associated with less post-operative pain and quicker recovery duration. However, the longer operative time of LESS-A compared with m-LA is a drawback.

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Laparo-endoscopic single-site left adrenalectomy using conventional ports and instruments

Cited by 2 publications

References 14 publications

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Laparoendoscopic single-site surgery adrenalectomy - own experience and matched case-control study with standard laparoscopic adrenalectomy.

Laparoendoscopic single-site adrenalectomy versus multi-port laparoendoscopic adrenalectomy: A systemic review and meta-analysis

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