Initial Experience with Laparoendoscopic Single-Site Surgery by Use of a Homemade Transumbilical Port in Urology
이석영, 김용태, 박해영, Lee Tchun Yong, 박성열,
소속 상세정보
이석영 ( Lee Seok-Young )
한양대학교 의과대학 비뇨기과학교실
김용태 ( Kim Yong-Tae )
한양대학교 의과대학 비뇨기과학교실
박해영 ( Park Hae-Young )
한양대학교 의과대학 비뇨기과학교실
( Lee Tchun Yong )
한양대학교 의과대학 비뇨기과학교실
박성열 ( Park Sung-Yul )
한양대학교 의과대학 비뇨기과학교실
KMID : 0358320100510090613
Abstract
PurposeWe present our initial experience with laparoendoscopic single-site surgery (LESS) by a single surgeon in the urologic field.
Materials and MethodsFrom May 2009 to April 2010, 30 consecutive patients underwent LESS including seven cases of nephrectomy, five cases of nephroureterectomy with bladder cuff excision, four cases of ureterolithotomy, eight cases of marsupialization, and six cases of varicocelectomy. We performed a retrospective analysis of the medical records of the above patients. The single port was made with a surgical glove and an Alexis® wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA). The wound retractor was put into the peritoneal space through an umbilical incision, and a laparoscopic triangle was secured by crossing both instruments. All operations were performed by the transperitoneal approach.
Results Mean patient age was 54.8 years. Mean operative time was 171.2±109.1 minutes. Mean estimated blood loss was 265.0±395.5 ml. Mean incision length was 3.2±1.4 cm. Mean length of hospitalization was 5.2±2.9 days. There was one laparoscopic conversion and two open conversions. There were two cases of transient ileus that improved with conservative treatment. Mean visual analogue pain scales on the operative day and first postoperative day were 6.3/10 and 3.1/10, respectively.
ConclusionsIn our experience, LESS for urologic surgery is feasible, safe, and clinically applicable. We consider the homemade single-port device to be a relatively cost-effective and convenient device. If surgical instruments for LESS and appropriate ports specified for LESS are developed, LESS would be a surgical treatment technique that could be used as an alternative to the conventional types of laparoscopic surgery.
키워드
Instrumentation;Laparoscopy;Surgical gloves;Urology
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