Single-Port Laparoscopic Retroperitoneal Surgery Using a Modified Single-Port Device in Urology

Shi, Lei; Cai, Wei; Dong, Jingcheng; Zhang, Xu; Gao, Jiangping; Song, Tao; Sun, Song; Zu, Qiang; Wang, Wei

doi:10.1159/000350937

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…According to the older literature, the upper size limit of lesions eligible for laparoscopy was 6 cm, while larger diameters constituted a relative contraindication to the procedure [3,4]. The indications gradually extended to larger lesions; therefore, it has quickly become the gold standard for the treatment of all benign adrenal tumors [5,6,7,8,9,10]. Although this procedure is considered relatively safe, outcomes vary depending on different factors; among them tumor size is frequently listed.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

Natkaniec¹,

Pędziwiatr²,

Wierdak³

et al. 2016

Urol Int

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Background: Laparoscopic adrenalectomy is the gold standard for treatment of benign adrenal lesions. Tumor size is a factor that might influence decision-making concerning the use of laparoscopic approach. The aim of this study was to analyze the results of adrenalectomy for tumors ≥6 cm in diameter. Methods: Two groups of patients were analyzed: first group comprised 441 patients with tumors <6 cm in diameter and second group consisted of 89 patients with tumors ≥6 cm. Both groups were compared with regard to the duration of surgery, intraoperative blood loss, conversion and complications rate. Results: Median duration of surgery in groups 1 and 2 amounted to 86.6 and 111.9 min (p < 0.0001), respectively. Median intraoperative blood loss in groups 1 and 2 was 56.5 and 172.8 ml (p < 0.0001), respectively. There was a linear relationship between tumor size and the duration of surgery, and between tumor size and intraoperative blood loss (p < 0.0001). There were 2 (0.5%) and 6 (6.7%) conversions in groups 1 and 2, respectively. There were 41 (9.3%) and 14 (15.7%) complications in groups 1 and 2 (p = 0.0692), respectively. Conclusions: Laparoscopic adrenalectomy of tumors ≥6 cm is more difficult, but it can be regarded safe and beneficial for patients.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

Natkaniec¹,

Pędziwiatr²,

Wierdak³

et al. 2016

Urol Int

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“…[ 8 ] Even though SPOR had been reported in radical nephrectomy and adrenalectomy,[ 2 , 11 ] SPOR-PN was only reported in two previous case reports; however, no clear description of the technique was stated. [ 13 , 14 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 , 11 ] The technique has been reported several times for adrenalectomies and radical nephrectomies;[ 11 - 14 ] however, only anecdotal case reports were found in the literature for PN. [ 13 , 14 ] In this article, we describe the techniques and outcomes of what, to our knowledge, represents the first SPOR-PN case series in Europe.…”

Section: Introductionmentioning

confidence: 99%

Single-port retroperitoneoscopic partial nephrectomy: Initial description and standardisation of technique

Vázquez-Martul

Iglesias-Alvarado

Altez-Fernandez

et al. 2022

Journal of Minimal Access Surgery

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Introduction: Minimally invasive surgery has been established as the gold standard for the treatment of localised renal tumours. A retroperitoneal approach is a feasible option with advantages in posterior tumours and patients with previous abdominal surgeries. In this context, single-port retroperitoneoscopic partial nephrectomy (SPOR-PN) has not been widely explored and developed. We present this technique’s description and our first results. Methods: We present a case series of nine patients undergoing SPOR-PN in a single institution. We used a multi-channel single-port access dispositive through a 35 mm incision below the 12 th rib, a 30° two-dimensional laparoscope, curved graspers and needle drivers on the left hand and standard rigid material in the right hand. In all surgeries, we performed a complete renorrhaphy with the sliding-clip technique. The pain was evaluated through visual analogue scale (VAS) the day after surgery. Results: Patients’ age ranged from 44 to 78 years. The median RENAL score was 5p, and the mean surgical time was 134 min. We performed an ‘off-clamp’ procedure on three patients. Among the patients who had renal artery clamped, the median ischaemia time was 18 min. The median in-hospital stay time was 48 h. Median VAS the day after surgery was 2. None of the anatomical pieces had positive borders. Only one complication was reported (Clavien IIIa). Conclusions: SPOR-PN is a feasible minimally invasive and nephron-sparing technique. The advantages of this procedure may not be only a better cosmetic appearance but also less post-operative pain. Further development and larger studies are needed.

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“…Concerning the anatomical adjacency relation of the splanchnic nerves with kidney, and that the operations on kidney and adrenal gland performed with retroperitoneal laparoscopy have been proved effective in the clinical practice, we supposed that the incision and surgical approach of retroperitoneal laparoscopic resection of adrenal tumor could be taken for reference (Shi et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

The Anatomy for Retroperitoneal Laparoscopic Splanchnicectomy

Yang

et al. 2017

Int. J. Morphol.

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SUMMARY:Greater splanchnic nerves (GSNs) and lesser splanchnic nerves (LSNs) are the dominant nerves in the pain of advanced cancer patients, which provides the base of retroperitoneal laparoscopic splanchnicectomy. We dissected 25 cadavers to provide anatomic basis for the surgery. Most GSNs entered the abdominal cavity close to the medial crus of the diaphragm while most LSNs the middle one. The number of the branch varies from 1 (which was 80 %) -3. The abdominal segment length of LSNs and GSNs was 26 mm and 20 mm respectively. The mean diameter of the nerves was about 2 mm. The laparoscope was put through abdominal wall beneath the 12 th rib at the posterior axillary line, best angles and distances for the surgery were 50 ° and 80-110 mm respectively. The anatomic parameters of splanchnic nerves in the abdominal cavity as well as the angle and distance for the retroperitoneal laparoscopic splanchnicectomy and the anatomic landmarks were presented by the study. Besides the advantages of small incision, less pain and quick recovery, the anatomic parameters provided a practicable approach for the retroperitoneal laparoscopic splanchnicectomy.

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Single-Port Laparoscopic Retroperitoneal Surgery Using a Modified Single-Port Device in Urology

Cited by 4 publications

References 28 publications

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

Laparoscopic Transperitoneal Lateral Adrenalectomy for Large Adrenal Tumors

Single-port retroperitoneoscopic partial nephrectomy: Initial description and standardisation of technique

The Anatomy for Retroperitoneal Laparoscopic Splanchnicectomy

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