Single-Port Transvesical Simple Prostatectomy: Initial Clinical Report

Desai, Mihir; Aron, Monish; Canes, David; Fareed, Khaled; Carmona, Oswaldo; Haber, Georges-Pascal; Crouzet, Sébastien; Astigueta, Juan Carlos; González-López, Raquel; Andrade, Robert De; Stein, Robert J.; Ulchaker, James; Sotelo, René; Gill, Inderbir S.

doi:10.1016/j.urology.2008.06.007

Cited by 126 publications

(67 citation statements)

References 4 publications

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“…The R-port device was introduced percutaneously into the bladder through a 2.5-cm incision under cystoscopic guidance [57]. Sotelo and his group also detailed their technique of the simple prostatectomy using a single multilumen port [58].…”

Section: Pelvic Surgerymentioning

confidence: 99%

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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: Pelvic Surgerymentioning

confidence: 99%

“…Medium Risk for prolonged warm ischemia time. Simple prostatectomy [57][58][59] Very difficult Availability of other, established techniques (eg, TURP, HoLEP, PVP).…”

Section: Highmentioning

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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“…The adenoma was extracted through the solitary skin and bladder incision after bivalving the prostate lobes within the bladder. 62 Sotelo et al also detailed the technique of the LESS simple prostatectomy for benign prostatic hyperplasia using a single multilumen port inserted through a solitary 2.5-cm intra-umbilical incision. Standard ultrasonic shears and needle drivers, articulating scissors and specifically designed bent grasping instruments facilitated dissection and suturing.…”

Section: Less and Notes In Urologymentioning

confidence: 99%

Current status and future perspectives in laparoendoscopic single‐site and natural orifice transluminal endoscopic urological surgery

et al. 2010

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Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been succesfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

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“…Different endolaparoscopic procedures using this approach were seen to be feasible and safe, [9][10][11][12] there still is no proven advantage of this technique over conventional endolaparoscopy. We believe that decreasing the number of incisions and increasing the number of procedures done will be the great advantage of single port surgery.…”

Section: Discussionmentioning

confidence: 99%