Retroperitoneoscopic laparo-endoscopic single-site radical nephrectomy (RLESS-RN): initial experience with a homemade po
- PDF / 195,438 Bytes
- 4 Pages / 595.28 x 793.7 pts Page_size
- 46 Downloads / 189 Views
WORLD JOURNAL OF SURGICAL ONCOLOGY
TECHNICAL INNOVATIONS
Open Access
Retroperitoneoscopic Laparo-endoscopic Singlesite Radical Nephrectomy (RLESS-RN): initial experience with a homemade port Shiu-Dong Chung1,2,3†, Chao-Yuan Huang2†, Yao-Chou Tsai3, Shih-Chieh Chueh2,4, Shun-Fa Hung1,2, Shuo-Meng Wang2*, Chun-Hou Liao5 and Hong-Jeng Yu2
Abstract We successfully performed 6 LESS radical nephrectomy via the retroperitoneal approach (RLESS) using the Alexis wound retractor as a single access with conventional laparoscopic instruments. The results demonstrated that our RLESS technique of radical nephrectomy is a safe and feasible procedure for management of localized renal cancer. Keywords: Laparoendoscopic single-site surgery, LESS, nephrectomy, Retroperitoneum, renal cancer
Background The novel technique laparoendoscopic single-site surgery (LESS) have been successfully performed in various urological operations that aim at performing laparoscopic surgery by consolidating all ports within a single skin incision, often concealed within the umbilicus and the transperitoneal route is typically employed [1-3]. The most obvious advantage of LESS is its cosmetic outcome when compared with conventional laparoscopic procedure [4]. Traditional laparoscopic techniques for radical nephrectomy usually need four to five trocars because retraction of intraabdominal organs is necessary [5-7]. There have been only limited reports of retroperitoneoscopic LESS procedures, and retroperitoneoscopic LESS nephrectomy was only reported very rarely, with limited case numbers, using variable LESS access platforms [8-10]. The present study retrospectively reviewed our experience of evaluating the feasibility and safety of retroperitoneoscopic LESS radical nephrectomy (RLESS-RN). Methods Since June 2010, retroperitoneal LESS radical nephrectomy (RLESS-RN) has been performed in 6 patients. * Correspondence: [email protected] † Contributed equally 2 Department of Urology. National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan Full list of author information is available at the end of the article
Perioperative data were collected retrospectively into our institutional review board-approved data registry and informed patient consent. All procedures were performed through the retroperitoneal approach. Operative technique
After the induction of general endotracheal anaesthesia, the patient was placed in a full flank position. The operating table was flexed at the waist level and the patient was securely fixed on the operating table with all pressure points well padded. Both the operator and the first assistant as the camera holder stood on the back side of the patient. All RLESS-RN was started from establishing retroperitoneoscopic working space by our previous reported method [11], with the open Hasson’s technique and the modification that the space was dilated with the Preperitoneal Dissector Balloon (PDB 1000; Covidien, Mansfield, MA, USA) under the direct vision of a 0° 10mm telescope instea
Data Loading...
