Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan

Sato, Fuminori; Nakagawa, Ken; Kawauchi, Akihiro; Matsubara, Akio; Okegawa, Takatsugu; Habuchi, Tomonori; Yoshimura, Koji; Hoshi, Akio; Kinoshita, Hidefumi; Miyajima, Akira; Naitoh, Yasuyuki; Inoue, Shogo; Itaya, Naoshi; Narita, Shintaro; Hanai, Kazuya; Okubo, Kazutoshi; Yanishi, Masaaki; Matsuda, Tadashi; Terachi, Toshiro; Mimata, Hiromitsu

doi:10.1111/iju.13235

Cited by 12 publications

(4 citation statements)

References 31 publications

(87 reference statements)

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“…1,2 The article by Sato et al presents a multi-institutional study evaluating the surgical outcomes of urological LESS surgery, including the safety and feasibility of the procedure, at nine university centers in Japan. 3 The authors retrospectively presented 469 consecutive patients undergoing LESS surgery for a wide range of urological diseases. According to the authors, the study is the second largest series of diverse LESS urological surgery.…”

Section: Editorial Commentmentioning

confidence: 99%

Editorial Comment to Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan

Gołębiewski

2016

Int J of Urology

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The article by Sato et al. presents a multi-institutional study evaluating the surgical outcomes of urological LESS surgery, including the safety and feasibility of the procedure, at nine university centers in Japan. 3 The authors retrospectively presented 469 consecutive patients undergoing LESS surgery for a wide range of urological diseases. According to the authors, the study is the second largest series of diverse LESS urological surgery. The most common procedures were adrenalectomy and nephrectomy (37.7% and 30.5%, respectively). The conversion rate (8.7%), intraoperative complications (2.1%), postoperative complications (6.2%) and median operative time were comparable with other series.1,4 Noteworthy is that at least one additional instrument was used in 28% of patients. Nearly all radical prostatectomy and pyeloplasty procedures required additional miniport or needlescopic instrument. The authors conclude that non-robotic LESS surgery is safe and technically feasible for patients with a broad range of urological diseases, and can be safely carried out by experienced urological surgeons in intermediate-volume centers.Though the presented approach is feasible in urological patients, there are obvious limitations of the study. The retrospective nature of the report, heterogeneity of patients, differences in surgical approaches and instrumentations, and lack of control group limit the value of research. These limitations are acceptable because of the fact that the technique is in its developing stages. The presented data showed that a broad range of procedures can be effectively and safely carried out.LESS as a still emerging surgical technique that requires clinical validation. Introduced advances in surgical technique should be primarily aimed at improving patient safety and outcomes. Further studies have to answer the question as to whether this treatment is less invasive for patients and improves cosmesis, and more importantly, whether introducing the LESS approach would or would not compromise oncological outcomes. Although the feasibility of the LESS technique has been shown, the role of LESS in mini-invasive urological surgery is still not clearly established and, ideally, this advanced approach should be compared with the standard laparoscopy in a prospective, randomized, multicenter trial before gaining general acceptance.

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Section: Editorial Commentmentioning

confidence: 99%

Editorial Comment to Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan

Gołębiewski

2016

Int J of Urology

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“…Laparoendoscopic single‐site surgery (LESS) techniques have been widely proposed for various procedures; however, its adoption had been previously limited by its steep learning curve and technical constraints, such as clashing instruments, limited operative space, and difficulties in triangulation 8 . Continuous development and technological progress have allowed recent iterations to overcome these obstacles and shortcomings.…”

Section: Introductionmentioning

confidence: 99%

Single‐port versus multiport robotic‐assisted radical prostatectomy: A systematic review and meta‐analysis on the da Vinci SP platform

et al. 2022

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Context Prostate cancer is the most common cancer in men; robotic prostatectomy has cemented itself as part of the standard of care. Since its approval by the Food and Drug Administration in 2018, the SP console's application has been increasingly studied and compared with the multiport (MP) robotic approach. Methods Following PRISMA guidelines and PROSPERO registration CRD42021228744, a systematic review was performed in April 2021 on single‐port robotic‐assisted radical prostatectomies (SP‐RARPs) compared to MP. Outcomes of interest were operative time, bleeding, complications, analgesic use, and postoperative continence, and erectile function. Data were analyzed with Review Manager 5.3. Results Seven studies were included, of which six studies met the inclusion criteria for quantitative synthesis, totalling 1068 patients, out of which 324 underwent SP‐RARP and 744 underwent MP‐RARP. No differences were found in baseline characteristics such as age, body mass index, prostatic‐specific antigen, or stage. No differences in blood loss—15.77 mL [−42.44, 10.89], p = 0.25, operative time 3.93 min [−4.12, 11.98], p = 0.34, or positive surgical margins, with an odds ratio (OR) of 0.78 [0.55, 1.10], p = 0.15—were found. Length of stay was significantly shorter in SP −0.94 days [−1.56, −0.33], p = 0.003, with no differences in complication rates, with an OR of 1.29 [0.78, 2.14], p = 0.32, continence rates, with an OR of 1.29 [0.90, 1.83], p = 0.16, erectile function, with an OR of 0.86 [0.52, 1.40], p = 0.54, or biochemical recurrence. Qualitative evidence suggests decreased opioid consumption. Conclusion SP‐RARPs are feasible alternatives to the traditional MP with possible benefits in pain management and length of stay. Future high‐quality studies are needed to confirm these findings.

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“…Sato et al reported that 469 single-site surgeries were carried out between February 2009 and December 2012 at nine academic institutions in Japan. Radical prostatectomy was carried out in only six cases [6]. However, adding one or two port, reduced port surgery is easier than single-port surgery.…”

Section: Introductionmentioning

confidence: 99%

Reduced Port Extraperitoneal Laparoscopic Radical Prostatectomy

Araki¹,

Naya²

2019

Prostatectomy

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Robot-assisted laparoscopic prostatectomy (RALP) is more popular than laparoscopic radical prostatectomy (LRP) in twenty-first century. However, RALP is still an expensive surgery. Open radical prostatectomy (ORP) was a gold standard and not an expensive surgery. However, ORP is not minimum invasive. LRP is relative expensive and minimum invasive. The problem of RALP or LRP is necessary to spread the wound for removing prostate and the pain of wound is often a problem. Using U-shaped incision at umbilicus, spreading the wound is not necessary to remove prostate. Single-port surgery is a challenging procedure for surgeons in spite of faster recovery and higher patient satisfaction than conventional laparoscopy. Adding one or two port, reduced port surgery is easier than single-port surgery. Reduced port LRP is an extension of conventional LRP. The procedure is as same as conventional LRP. Curved or flexible instruments are not always necessary in the reduced port LRP. Reduced port LRP has less pain and better cosmetics than conventional LRP because the prostate is removed from the umbilicus. It is not necessary to spread the wound for removing prostate.

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Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan

Cited by 12 publications

References 31 publications

Editorial Comment to Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan

Editorial Comment to Laparoendoscopic single‐site surgeries: A multicenter experience of 469 cases in Japan

Single‐port versus multiport robotic‐assisted radical prostatectomy: A systematic review and meta‐analysis on the da Vinci SP platform

Reduced Port Extraperitoneal Laparoscopic Radical Prostatectomy

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