Single Port Transumbilical (E-NOTES) Donor Nephrectomy

Gill, Inderbir S.; Canes, David; Aron, Monish; Haber, Georges-Pascal; Goldfarb, David A.; Flechner, Stuart M.; Desai, Mahesh; Kaouk, Jihad; Desai, Mihir

doi:10.1016/j.juro.2008.04.028

Cited by 306 publications

(187 citation statements)

References 9 publications

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“…The most important merit of RPS is cosmesis [3,4,6,9,11,13]. Therefore, this cosmetic merit must be retained as long as possible when performing RPS for total gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, reduced port surgery (RPS), including single port surgery (SPS), in which fewer ports are used than in conventional procedures, has become increasingly popular in various surgical fields [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. There have been reports describing the application of RPS to laparoscopic sleeve gastrectomy for morbid obesity or laparoscopic partial gastrectomy for gastrointestinal stromal tumors, and the use of RPS has recently also been reported in laparoscopy-assisted distal gastrectomy for gastric cancer [1,7,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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The initial experience of dual port laparoscopy-assisted total gastrectomy as a reduced port surgery for total gastrectomy

et al. 2012

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Reduced port surgery (RPS), in which fewer ports are used than that in a conventional laparoscopic procedure, is becoming increasingly popular for various surgeries. However, the application of RPS to the field of gastrectomy is still underdeveloped. We started laparoscopy-assisted total gastrectomy through an umbilical port plus another 5 mm port (dual port laparoscopy-assisted total gastrectomy: DP-LATG) as an RPS for laparoscopyassisted total gastrectomy (LATG). A SILS TM port was inserted into an umbilical incision, while another 5 mm port was inserted at the right flank region. We performed DP-LATG on ten early gastric cancer cases consecutively from May 2011 onwards, with the surgeries all performed by a single surgeon. The results of DP-LATG were compared with the resuls of ten conventional LATGs (C-LATGs) that were performed between March 2010 and April 2011. There were no significant differences in the mean operation time (DP-LATG, 253.0 ± 26.8 min; C-LATG, 235.5 ± 20.6 min; p = 0.119), mean blood loss (33.4 ± 23.7, 39.8 ± 60.4 mL, p = 0.759), and number of lymph nodes dissected (31.6 ± 12.3, 40.9 ± 18.7, p = 0.205). There were no intraoperative complications, there was no need for additional ports, and there were no conversions to open surgery nor postoperative complications in the DP-LATG cases. We successfully and safely performed DP-LATG without incurring any notable differences from C-LATG in terms of operation time, blood loss, and number of lymph nodes dissected.

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“…The most important merit of RPS is cosmesis [3,4,6,9,11,13]. Therefore, this cosmetic merit must be retained as long as possible when performing RPS for total gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The initial experience of dual port laparoscopy-assisted total gastrectomy as a reduced port surgery for total gastrectomy

et al. 2012

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“…Gill et al first reported the successful completion of single-port transumbilical live-donor nephrectomy [48]. The authors used the R-Port, achieving pneumoperitoneum by inserting an additional 2-mm Veress needle port.…”

Section: Opticsmentioning

confidence: 99%

“…Living-donor nephrectomy [48][49][50] Extremely difficult Risk of prolonged warm ischemia time/ Medium Risk of complication in a healthy individual. Radical prostatectomy [54][55][56] Extremely difficult Demanding suturing.…”

Section: Lowmentioning

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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“…Recently, many authors, including ourselves, have successfully described the role of the laparoendoscopic single-site surgery (LESS) by umbilical approach for urological pathologies (1)(2)(3)(4). The potential benefits are related to the minimization of skin morbidity (temporary incision pain and muscle spasms, avoidance of epigastric vessel injury) and the improved cosmesis.…”

Section: Introductionmentioning

confidence: 99%

Laparoendoscopic pfannenstiel nephrectomy using conventional laparoscopic instruments - preliminary experience

Branco¹,

Kondo²,

Stunitz³

et al. 2010

Int. braz j urol.

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Purpose: To confirm the feasibility of the laparoendoscopic Pfannenstiel nephrectomy using conventional laparoscopic instruments. Materials and Methods: Since March 2009, laparoscopic nephrectomy through a Pfannenstiel incision has been performed in selected patients in our service. The Veress needle was placed through the umbilicus which allowed carbon dioxide inflow. One 5 mm (or 10 mm) trocar was placed at the umbilicus for the laparoscope, to guide the placement of three trocars over the Pfannenstiel incision. Additional trocars were placed as follows: a 10 mm in the midline, a 10 mm ipsilateral to the kidney to be removed (2 cm away from the middle one), and a 5 mm contralateral to the kidney to be removed (2 cm away from the middle one). The entire procedure was performed using conventional laparoscopic instruments. At the end of the surgery, trocars were removed and all three incisions were united into a single Pfannenstiel incision for specimen retrieval. Results: Five nephrectomies were performed following this technique: one atrophic kidney, one kidney donation, two renal cancers and one bilateral renal atrophy. Median operative time was 100 minutes and median intraoperative blood loss was 100 cc. No intraoperative complications occurred and no patients required blood transfusion. Median length of hospital stay was 1 day (range 1 to 2 days). Conclusions: The use of the Pfannenstiel incision for laparoscopic nephrectomy seems to be feasible even when using conventional laparoscopic instruments, and can be considered a potential alternative for traditional laparoscopic nephrectomy.

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Single Port Transumbilical (E-NOTES) Donor Nephrectomy

Cited by 306 publications

References 9 publications

The initial experience of dual port laparoscopy-assisted total gastrectomy as a reduced port surgery for total gastrectomy

The initial experience of dual port laparoscopy-assisted total gastrectomy as a reduced port surgery for total gastrectomy

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

Laparoendoscopic pfannenstiel nephrectomy using conventional laparoscopic instruments - preliminary experience

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