Transumbilical laparoendoscopic single-site surgery of simple nephrectomy of nonfunctioning kidney: a two-year experience

BackgroundLaparoendoscopic single-site surgery (LESS) may serve as a potential alternative to conventional laparoscopy and is developing quickly, but still in its infancy. The study is to present our two-year experience in transumbilical LESS simple nephrectomy (LESS-SN) for non-functioning kidney, in an effort to evaluate its feasibility, clinical outcomes and potential advantages.MethodsFrom December 2008 to December 2010, a total of 11 patients with body mass index (BMI) ≤30 underwent transumbilical TriPort™ LESS-SN by a single experienced urologist at our institution. The indications for nephrectomy included nonfunctioning kidney associated with ureteropelvic junction stricture (n=1), ureteral calculi (n=6), tuberculosis (n=3), and ureteral stricture (n=1). Patient demographics, perioperative and follow-up data were prospectively collected and analyzed.ResultsTen procedures were successfully completed with one patient converted to open surgery due to uncontrollable bleeding. The mean operative time was 189.2 (ranging 100∼320 min) with an estimated blood loss of 204.5 (ranging 501 000 ml). There were two complications of bleeding (1 intra-, 1 post-). The mean hospitalization after surgery was 7.9 d (ranging 417 d). With a regular follow-up of 1, 6, 12, and 24 months after surgery, all patients remained symptom-free with an intra-umbilical scar.ConclusionTransumbilical LESS simple nephrectomy for nonfunctioning kidney can be accomplished with favorable surgical outcomes and a superiority of cosmesis. However, cases with chronic inflammation are not suitable for initial up-take and should only be attempted by the very experienced laparoscopist.