Comparison of laparoendoscopic single site (<scp>LESS</scp>) and conventional laparoscopic donor nephrectomy at a single institution

Stamatakis, Lambros; Mercado, Miguel Ángel; Choi, Jong-Woo; Sanchez, Edward J.; Gaber, A. Osama; Knight, Richard J.; Mayer, Wesley A.; Link, Richard E.

doi:10.1111/j.1464-410x.2012.11763.x

Cited by 32 publications

(18 citation statements)

References 21 publications

(24 reference statements)

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“…The majority of the studies described the evolution from ODN to LDN (22 studies). A few studies described the adaptation of retroperitoneal laparoscopic techniques, whereas five studies reported on the introduction of single‐incision laparoscopic techniques . Horgan et al.…”

Section: Resultsmentioning

confidence: 99%

Training techniques in laparoscopic donor nephrectomy: a systematic review

Raque

Billeter

Lucich

et al. 2015

Clinical Transplantation

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The learning curve to achieve competency in laparoscopic donor nephrectomy (LDN) is poorly outlined. Online databases were searched for training in LDN. Abstracts and manuscripts were excluded if they did not address introduction of a laparoscopic technique for donor nephrectomy. Relevant manuscripts were reviewed for surgical technique, use of animal models, co-surgeons, surgeon specialty and training, institution type/volume, and assessment of training method. Forty-four met inclusion criteria, with 75% describing the evolution from open to LDN. Eighty-two percent were from academic centers, and 36% were from centers performing <25 donor nephrectomies each year. The learner was an attending surgeon 80% of the time, mostly urologists with prior laparoscopy or open nephrectomy experience. The learning curve, defined by decreased operating time, averaged 35 cases. Improved intra-operative, patient, and recipient outcomes were observed for centers performing ≥50 LDNs annually. The United Network of Organ Sharing requires 15 cases as surgeon or assistant to be certified as the primary LDN surgeon. This falls below the described learning curve for LDN. The assessment of training and competency for LDN is heterogeneous, and objective learner-based metrics could help surgeons and institutions reach a quality standard for performing this operation.

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Section: Resultsmentioning

confidence: 99%

Training techniques in laparoscopic donor nephrectomy: a systematic review

Raque

Billeter

Lucich

et al. 2015

Clinical Transplantation

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“…In addition to cosmetic advantages, patients may experience less postoperative pain and fewer port site‐related complications. Several institutions have reported using LESS for live donor nephrectomy (LESS‐DN) and other therapeutic/reconstructive renal procedures, showing similar perioperative outcomes and equivalent complication rates, with varying results related to donor recovery and cosmesis . Meta‐analysis of 27 studies comparing LESS versus laparoscopic nephrectomy in patients undergoing radical or partial nephrectomy for cancer, donor nephrectomy or mixed procedures found LESS to be a safe and effective alternative with potential benefits of reduced pain, shorter recovery and improved cosmesis .…”

Section: Introductionmentioning

confidence: 99%

A Randomized, Prospective, Parallel Group Study of Laparoscopic Versus Laparoendoscopic Single Site Donor Nephrectomy for Kidney Donation

Aull

Afaneh

Charlton

et al. 2014

American Journal of Transplantation

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Few prospective, randomized studies have assessed benefits of laparoendoscopic single site donor nephrectomy (LESS-DN) over laparoscopic donor nephrectomy (LDN). Our center initiated such a trial in January 2011, following subjects randomized to LESS-DN vs. LDN from surgery through 5 years post-donation. Subjects complete recovery/satisfaction questionnaires at 2, 6, and 12 months post-donation; transplant recipient outcomes are also recorded. 100 subjects (49 LESS-DN, 51 LDN) underwent surgery; donor demographics were similar between groups, and included a predominance of female, living unrelated donors, mean age of 47 years who underwent left donor nephrectomy. Operative parameters (overall time, time to extraction, warm ischemia time, blood loss) were similar between groups. Conversion to hand-assist laparoscopy was required in 3 LESS-DN (6.1%) vs. 2 LDN (3.9%; P=0.67). Questionnaires revealed 97.2% of LESS-DN vs. 79.5% of LDN (P=0.03) were 100% recovered by two months after donation. No significant difference was seen in satisfaction scores between the groups. Recipient outcomes were similar between groups. Our randomized trial comparing LESS donor nephrectomy to LDN confirms that LESS-DN offers a safe alternative to conventional LDN in terms of intra- and post-operative complications. LDN and LESS-DN offer similar recovery and satisfaction after donation.

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“…Key words: Cholecystectomy; laparoscopy; single-incision laparoscopic surgery (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

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confidence: 99%

Extraumbilical Single-Incision Laparoscopic Cholecystectomy with Standard Laparoscopic Instruments

Oruç

Uğurlu

2013

Scand J Surg

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Background and Aim: Single-incision laparoscopic surgery is a rapidly progressing field as it combines some advantages such as cosmesis and less incisional pain. However, it also has some disadvantages such as limitation of movement and clashing of the hand instruments, which increase the complexity and technical challenges of the operation. In this study, we describe a pilot trial of single-incision laparoscopic cholecystectomy through a paramedian access site.Material and Methods: A total of 25 patients underwent single-incision laparoscopic cholecystectomy with this method. Acute cases with empyema and patients with history of previous abdominal surgery were excluded. Single-incision is established on the right upper quadrant, right latero-superior of the umbilicus, so that trocar sites and projection of the gallbladder on the abdominal wall are on the same vertical line. Standard laparoscopic instruments were placed into the abdominal cavity providing triangulation. Once the laparoscope, grasper, and dissector are in place, the overall procedures are similar to the standard laparoscopic cholecystectomy.Results: Single-incision laparoscopic cholecystectomy through an extraumbilical access site was successfully completed in all 25 patients without conversion to open surgery. Additional skin incisions and trocar access were required only in two patients. The mean operative time was 39.3 min (range: 20-75 min). The mean body mass index was 27.2. Postoperative course was uneventful in all patients. The mean postoperative hospital stay was shorter than 24 h, and all patients were discharged at first day postoperatively. No postoperative complications including seroma, wound infection, and trocar-site hernia were observed at 6-month follow-up.Conclusion: We described a new access site for single-incision laparoscopic cholecystectomy using standard laparoscopic instruments. We believe that this type of

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Comparison of laparoendoscopic single site (LESS) and conventional laparoscopic donor nephrectomy at a single institution

Cited by 32 publications

References 21 publications

Training techniques in laparoscopic donor nephrectomy: a systematic review

Training techniques in laparoscopic donor nephrectomy: a systematic review

A Randomized, Prospective, Parallel Group Study of Laparoscopic Versus Laparoendoscopic Single Site Donor Nephrectomy for Kidney Donation

Extraumbilical Single-Incision Laparoscopic Cholecystectomy with Standard Laparoscopic Instruments

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