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Urologic robot-assisted laparoendoscopic single-site surgery using a homemade single-port device: a single-center experience of 68 cases

 Jae Won Lee  ;  Francis Raymond P. Arkoncel  ;  Koon Ho Rha  ;  Kyung Hwa Choi  ;  Ho Song Yu  ;  Yunbyung Chae  ;  Woong Kyu Han 
 JOURNAL OF ENDOUROLOGY, Vol.25(9) : 1481-1485, 2011 
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Adolescent ; Adult ; Aged ; Aged, 80 and over ; Humans ; Intraoperative Care ; Laparoscopy/instrumentation* ; Middle Aged ; Operating Rooms ; Postoperative Care ; Robotics/instrumentation* ; Surgical Instruments* ; Urologic Surgical Procedures/instrumentation* ; Young Adult
PURPOSE: To describe our experience with robot-assisted laparoendoscopic single-site (R-LESS) surgeries and evaluate a homemade port system as an effective access technique. PATIENTS AND METHODS: Between May 2009 and April 2010, 68 consecutive R- LESS urologic operations were performed in our institution. A 4 to 5 cm long incision was made over the umbilicus. After the inner ring of the Alexis wound retractor was placed into the peritoneum, a common size 7 surgical glove was then applied over the external side of the wound retractor. A homemade single port was established by inserting two 12-mm trocars and two 8-mm trocars through fingers of a surgical glove and securing it to the port. RESULTS: Sixty-eight patients underwent R-LESS, including partial nephrectomy in 51, nephroureterectomy in 12, radical nephrectomy and adrenalectomy in 2 each, and simple nephrectomy in 1. Mean patient age was 56 years (range 16-81 y). Mean body mass index was 23.9 kg/m(2) (range 17.2-32.9 kg/m(2)). The mean operative time was 219 minutes (range 109-382 min). Mean estimated blood loss 319 mL (range 50-1550 mL), and change in hematocrit was 5.2 % (range 0.0-14.8%). At a mean follow-up of 8 months, there were no port-related complications, and cosmesis was excellent. CONCLUSIONS: R-LESS is feasible and can be safely applied to a variety of urologic operations, considering the low intraoperative complication rate. Our homemade single-port device provides adequate range of motion and is more flexible in port placement for R-LESS than the current multichannel port.
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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
Arkoncel, Francis Raymond P.(아르콘셀)
Yu, Ho Song(유호송)
Lee, Jae Won(이재원)
Chae, Yun Byung(채윤병)
Choi, Kyung Hwa(최경화)
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
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