Laparoendoscopic Single Site for Stone and UPJ Obstruction: Focusing on Traction,Stenting,and Suturing

Abstract

Introduction:

We aim to present our improved techniques for ureteral laparoendoscopic single site (LESS) surgery, focusing on tissue traction, stenting, and suturing.

Materials and Methods:

Among 150 patients who underwent LESS surgery in our institution (from December 2008 to April 2010), 3 cases of conventional LESS pyeloplasties and 7 cases of conventional LESS ureterolithotomies were performed using our techniques below. All procedures were done using a platform homemade port device with a size-7 nonpowdered surgical glove and the Alexis^® wound retractor, which was inserted through a 2-cm umbilical incision. During the operation we used percutaneous puncture technique for effective suture traction. The same method was adopted for intracorporeal stent insertion. ¹

Results and Conclusions:

In ureterolithotomy, mean operative time was 161 minutes (range, 102–227) and mean stone size was 1.7 cm (range, 1.1–2.4). In pyeloplasty, mean operative time was 207 minutes (range, 160–274). There were no complications in any patient. Percutaneous puncture approach avoids additional port placement for intracorporeal stent insertion. With adequate motion range provided by the homemade port device, all meticulous suturing for ureteral anastomosis was done. The extracted stone was removed through the homemade port device without using a retrieval bag. LESS surgeries using our improved techniques are feasible and safe for benign ureteral disease. With these techniques, LESS surgery can be more convenient and safely applied to various LESS urologic surgeries.

All authors have declared no conflicts of interest exist.

Runtime of video: 7 mins 46 secs