Laparoendoscopic Single-Site Pyeloplasty Using Additional 2 mm Instruments: A Comparison with Conventional Laparoscopic Pyeloplasty
주성호, 이동기, 이준호, 백민기, 전성수, 이규성, 한덕현, 정병창,
소속 상세정보
주성호 ( Ju Sung-Ho )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
이동기 ( Lee Dong-Gi )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
이준호 ( Lee Jun-Ho )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
백민기 ( Baek Min-Ki )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
전성수 ( Jeon Seong-Soo )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
이규성 ( Lee Kyu-Sung )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
한덕현 ( Han Deok-Hyun )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
정병창 ( Jeong Byong-Chang )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
KMID : 0358320110520090616
Abstract
Purpose: Despite a recent surge in the performance of laparoendoscopic single-site surgery (LESS), concerns remain about performing LESS pyeloplasty (LESS-P) because of the technical difficulty in suturing. We report our techniques and initial experiences with LESS-P using additional needlescopic instruments and compare the results with conventional laparoscopic pyeloplasty (CL-P).
Materials and Methods : Nine patients undergoing LESS-P were matched 2:1 with regard to age and side of surgery to a previous cohort of 18 patients who underwent CL-P. In both groups, the operating procedures were performed equally except for the number of access points. In the LESS-P group, we made a single 2 cm incision at the umbilicus and used a homemade port. We also used additional 2 mm needlescopic instruments at the subcostal area to facilitate suturing and the ureteral stenting.
Results: The preoperative characteristics were comparable in both groups. Postoperatively, no significant differences were noted between the LESS-P and CL-P cases in regard to length of stay, estimated blood loss, analgesics required, and complications. But, LESS-P was associated with a shorter operative time (252.2 vs. 309.7 minutes, p=0.044) and less pain on postoperative day one (numeric rating scale 3.7 vs. 5.6, p=0.024). The success rate was 94% with CL-P (median, 23 months) and 100% with LESS-P (median, 14 months).
Conclusions: Our initial experiences suggest that LESS-P is a feasible and safe procedure. The use of additional 2 mm instruments can help to overcome the difficulties associated with LESS surgery.
키워드
Laparoscopy;Minimally invasive;Surgical procedure;Ureteral obstruction
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