Retroperitoneoscopic Adrenalectomy for Adrenal Tumors via a Single Large Port

Hirano, Daisaku; Minei, Sadatsugu; Yamaguchi, Kenya; Yoshikawa, Toru; Hachiya, Takahiko; Yoshida, Toshio; Ishida, Hajime; Takimoto, Yukie; Saitoh, Takashi; Kiyotaki, Shuji; Okada, Kiyoki

doi:10.1089/end.2005.19.788

Cited by 139 publications

(69 citation statements)

References 18 publications

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“…Hirano et al were the first to report urologic singleincision surgery in 2005 [10]. They used a resectoscope tube and standard laparoscopic instruments to show the feasibility of retroperitoneoscopic adrenalectomy.…”

Section: Introductionmentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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LESS Natural orifice transluminal endoscopic surgery NOTES Robotics UrologyPlease visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery. Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology. Evidence acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology. Evidence synthesis: In urology, NOTES has been completed experimentally via transgastric, transvaginal, transcolonic, and transvesical routes. Initial clinical experience has shown that NOTES urologic surgery using currently available instruments is indeed possible. Nevertheless, because of the immaturity of the instrumentation, early cases have demanded high technical virtuosity. LESS can safely and effectively be performed in a variety of urologic settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low, mostly being small case series or casecontrol studies from selected centers. Thus, the only objective benefit of LESS remains the improved cosmetic outcome. Prospective, randomized studies are largely awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technology advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS and NOTES. Conclusions: NOTES is still an investigational approach in urology. LESS has proven to be immediately applicable in the clinical field, being safe and feasible in the hands of experienced laparoscopic surgeons. Development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

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Section: Introductionmentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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“…Initially there was reluctance to adopt the technique owing to lack of technic al facilitation; however, new or innovative port types 20 and newer instruments have led to its application in a variety of surgical specialities. 21 Laparoendoscopic single site TEP may be performed using conventional instruments, although articu lating or curved instruments are in use. 22 Although patients have good outcomes after conventional laparoscopic techniques, some authors suggest that there is a preference for LESS, 23 which may be because of less postoperative pain 24,25 or possible better cosmesis.…”

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confidence: 99%

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

Siddiqui

Kovzel

Brennan

et al. 2014

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“…SILS was first described in general surgery in 1997 to perform laparoscopic cholecystectomies 1,2 and appendicectomies 1,3 but enthusiasm was limited because of poor equipment and technical support. In 2005 a resurgence was initiated in urology by Hirano et al 4 Technical improvements that enabled this revival included bent or articulating instruments, adjustments in laparoscopes, several adjacently placed trocars through one incision and special multilumen ports that allow simultaneous multiple instrument insertion. 1 Many of the big healthcare manufacturers have seen this emerging market and new operative hardware is being developed to facilitate the technique.…”

Section: Discussionmentioning

confidence: 99%

Single incision laparoscopic surgery in general surgery: a review

Greaves

Nicholson

2011

annals

102

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Laparoscopic surgery has become the gold standard for many operative procedures in the last 20 years. Its advantages over open surgery are well documented; however, the drive to reduce the trauma of surgical access persists. Laparoscopic techniques utilising only one umbilical port may represent the next step in this surgical evolution. They have been given a myriad of names (single-port access surgery (SPA), one-port umbilical surgery (OPUS), transumbilical endoscopic surgery (TUES) etc) since their inception, with no standardised acronym to date. 1 Single incision laparoscopic surgery (SILS) is an umbrella term used in this article to encompass all such single incision laparoscopic techniques, which allow potentially 'scarless' surgery as the wound is hidden within the umbilicus. Many groups have reported on the feasibility of the technique and its initial success but there have been very few significant trials. There is still no consensus and this field therefore represents a major focus for research and development. A MEDLINE ® search using multiple Medical Subject Headings (MeSH) terms pertaining to this topic highlighted 464 relevant articles in the literature. This article aims to present the current possibilities offered by this technique within general surgery and the evidence supporting it. DiscussionThere is still much debate over whether SILS is the future of laparoscopic surgery or just a passing fad. SILS was first described in general surgery in 1997 to perform laparoscopic cholecystectomies 1,2 and appendicectomies 1,3 but enthusiasm was limited because of poor equipment and technical support. In 2005 a resurgence was initiated in urology by Hirano et al. 4 Technical improvements that enabled this revival included bent or articulating instruments, adjustments in laparoscopes, several adjacently placed trocars through one incision and special multilumen ports that allow simultaneous multiple instrument insertion. 1 Many of the big healthcare manufacturers have seen this emerging market and new operative hardware is being developed to facilitate the technique. Devices like the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) (Fig 1), the AirSeal ® (SurgiQuest Inc, Orange, CT, US) (Fig 3) and the SILS ™ port (Covidien, Norwalk, CT, US) have made single site surgery easier and more efficient. A return to SILS cholecystectomies followed and this is the most studied general surgery procedure using the technique. However, the repertoire of operations amenable to SILS is expanding and recently published papers describe SILS approaches for totally extraperitoneal inguinal hernia repair, 6 Single incision laparoscopic surgery (SILS) is a rapidly developing field that may represent the future of laparoscopic surgery. The major advantage of SILS over standard laparoscopic surgery is in cosmesis, with surgery becoming essentially scarless if the incision is hidden within the umbilicus. Only one incision is required so the risk of potential complications like port site hernias, haematomas and wound in...

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Retroperitoneoscopic Adrenalectomy for Adrenal Tumors via a Single Large Port

Abstract: This procedure appears to be effective and relatively minimally invasive. However, it is limited by the narrow working space and restriction of the manipulation of instruments.

Cited by 139 publications

References 18 publications

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

The role of the laparoendoscopic single site totally extraperitoneal approach to inguinal hernia repairs: a review and meta-analysis of the literature

Single incision laparoscopic surgery in general surgery: a review

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