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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 
 YONSEI MEDICAL JOURNAL, Vol.52(2) : 307-313, 2011 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Kidney Diseases/surgery ; Kidney Neoplasms/surgery ; Laparoscopy/methods* ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Nephrectomy/methods* ; Postoperative Care ; Treatment Outcome ; Umbilicus/surgery
Laparoendoscopic single-site surgery ; nephrectomy ; home-made transumbilical port ; modified umbilical incision
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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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yu, Ho Song(유호송)
Jang, Won Sik(장원식) ORCID logo https://orcid.org/0000-0002-9082-0381
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
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