Transumbilical Laparoendoscopic Single-Site Renal Pedicle Lymphatic Disconnection for Refractory Chyluria

Abstract

Purpose:

To report our preliminary techniques and experience with transumbilical laparoendoscopic single-site renal pedicle lymphatic disconnection (LESS-RPLD) in seven patients with refractory chyluria.

Patients and Methods:

Between June 2009 and September 2010, seven patients with refractory chyluria underwent LESS-RPLD. In the patients, a 2- to 3-cm single inverted U-shaped supraumbilical incision was made, and a homemade single multichannel port using a surgical glove and three conventional trocars was placed into the abdominal cavity. Flexible electric coagulation hook and pliers were used for renal pedicle dissection. A straight ultrasound knife was used for lymphatic disconnection.

Results:

All the operations were successfully completed without conversion to open surgery, although an additional 3-mm trocar was used to push the liver in one patient. The mean operative time was 125 (96–165) minutes. The mean blood loss was estimated to be 112 (50–250) mL. Chyluria disappeared in all patients after surgery and did not recur during the follow-up period (3–15, mean 8.3 mos).

Conclusion:

LESS-RPLD is safe and feasible, with favorable short-term outcomes and aesthetic effect.