Laparoendoscopic single-site nephrectomy using a modified umbilical incision and a home-made transumbilical port

Ho Song Yu, Won Sik Ham, Koon Ho Rha, Sang Won Han, Young Deuk Choi, Woong Kyu Han, Won Sik Chang

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the clinical utility of laparoendoscopic single-site surgery (LESS) nephrectomy using a modified umbilical incision and home-made transumbilical port in cases requiring extirpative surgery. Materials and Methods: Initial consecutive 18 patients underwent LESS nephrectomies that were performed by a single surgeon. A home-made port was placed through a modified umbilical incision, the length of which had preoperatively been determined. The laparoscopic transperitoneal nephrectomy procedures were performed with various combinations of standard and articulating laparoscopic instruments. Patient characteristics and perioperative outcomes, including pathologic results, were recorded prospectively. Results: All 18 extirpative surgeries, including simple nephrectomy (eight cases), radical nephrectomy (nine cases), and nephroureterectomy (one case), were completed successfully. The median operation time was 167 min (range 82-220), and the median blood loss was 250 mL (range 0-1050). All specimens were extracted intact through a modified umbilical incision (median length 2.5 cm, range 1.5-6.0). Final pathological analysis revealed a nonfunctioning kidney in five cases, a dysplastic kidney in three cases, a mixed epithelial and stromal tumor in one case, renal cell carcinoma in eight cases (T1: five cases, T3: three cases), and Ta ureter transitional cell carcinoma in one case. Conclusion: LESS nephrectomy using a home-made port and modified umbilical incision is feasible with both minimal incision and cost-effective. Our technique may be more useful for extirpative procedures in which a specimen needs to be removed intact, because incision length can be freely adjusted. Prospective comparisons are warranted to more clearly elucidate the utility of this surgical technique.

Original languageEnglish
Pages (from-to)307-313
Number of pages7
JournalYonsei medical journal
Volume52
Issue number2
DOIs
Publication statusPublished - 2011 Mar 1

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Umbilicus
Nephrectomy
Kidney
Transitional Cell Carcinoma
Ureter
Renal Cell Carcinoma
Costs and Cost Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Laparoendoscopic single-site nephrectomy using a modified umbilical incision and a home-made transumbilical port",
abstract = "Purpose: To assess the clinical utility of laparoendoscopic single-site surgery (LESS) nephrectomy using a modified umbilical incision and home-made transumbilical port in cases requiring extirpative surgery. Materials and Methods: Initial consecutive 18 patients underwent LESS nephrectomies that were performed by a single surgeon. A home-made port was placed through a modified umbilical incision, the length of which had preoperatively been determined. The laparoscopic transperitoneal nephrectomy procedures were performed with various combinations of standard and articulating laparoscopic instruments. Patient characteristics and perioperative outcomes, including pathologic results, were recorded prospectively. Results: All 18 extirpative surgeries, including simple nephrectomy (eight cases), radical nephrectomy (nine cases), and nephroureterectomy (one case), were completed successfully. The median operation time was 167 min (range 82-220), and the median blood loss was 250 mL (range 0-1050). All specimens were extracted intact through a modified umbilical incision (median length 2.5 cm, range 1.5-6.0). Final pathological analysis revealed a nonfunctioning kidney in five cases, a dysplastic kidney in three cases, a mixed epithelial and stromal tumor in one case, renal cell carcinoma in eight cases (T1: five cases, T3: three cases), and Ta ureter transitional cell carcinoma in one case. Conclusion: LESS nephrectomy using a home-made port and modified umbilical incision is feasible with both minimal incision and cost-effective. Our technique may be more useful for extirpative procedures in which a specimen needs to be removed intact, because incision length can be freely adjusted. Prospective comparisons are warranted to more clearly elucidate the utility of this surgical technique.",
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Laparoendoscopic single-site nephrectomy using a modified umbilical incision and a home-made transumbilical port. / Yu, Ho Song; Ham, Won Sik; Rha, Koon Ho; Han, Sang Won; Choi, Young Deuk; Han, Woong Kyu; Chang, Won Sik.

In: Yonsei medical journal, Vol. 52, No. 2, 01.03.2011, p. 307-313.

Research output: Contribution to journalArticle

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AU - Yu, Ho Song

AU - Ham, Won Sik

AU - Rha, Koon Ho

AU - Han, Sang Won

AU - Choi, Young Deuk

AU - Han, Woong Kyu

AU - Chang, Won Sik

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