Comparative study between Umbilical Laparoendoscopic Single-site Surgery and Retroperitioneal Laparoendoscopic Single-site Surgery in urology (166 cases report)
He Zhengyu1, 2, Yang Junfeng2, Yu Yanhong2, Shen Jie2, Xiao Long2
1 Yunnan University of Traditional Chinese Medicine, Kunming 650032, China;
2 Department of Urology, the First People's Hospital of Yunnan Province
Abstract：Objective: To compare the umbilical laparoendoscopic single-site surgery and retroperitioneal laparoendoscopic single-site surgery in urology. Methods: From June 2011 to November 2016, 166 patients (193 sides) were subjected to laparoendoscopic single-site surgery (LESS) in our institute. There were 58 males and 108 females, and the average age was 31 years (2-53 years). The average body mass index (BMI) was 20.4 (16.5-26.8). The transumbilical approach was used in 129 cases, and translumbar approach in 37 cases. There were 98 cases for adrenal and renal surgery, 32 cases for ureter and bladder surgery, 36 cases for gonad and spermatic cord surgery. There were 27 cases of bilateral lesions, 33 cases of neoplastic lesions, and 48 cases were given suture. All the surgical procedures were performed by self-made "1-ring 3-channel" device, 10 mm or 5 mm 30° laparoscope and general laparoscopic instrument. Laparoscopic knot (48 cases) and D-J stent implantation (41 cases) were completed by modified method. There were 28 cases receiving needle thread traction to increase the surgical exposure. Results: All the operations were completed successfully. Among them, 5 cases were conversed to 2-3 site laparoscopic surgery. The average operative time was 95 min (15-335 min), and the average blood loss was 45 mL (5-600 mL). The average postoperative hospital stay was 5.5 d (1-12 d). Seventy-three patients were given analgesic postoperatively. Perioperative complications occurred in 12 patients. 157 cases were followed up for 1 month to 5 years. They were satisfied with incision healing. The Vancouver scar score was 3.3 points for the transumbilical approach, and 4.2 points for the translumbar approach. Conclusions: It is safe to use self-made "1 ring 3 channel" and common instrument to implement urological single-site laparoscopic surgery. The modified method for indwelling D-J tube, laparoscopic knot, and the needle thread traction could improve the efficiency of LESS. The transumbilical surgery has a better cosmetic effect and less pain than the other, more suitable for woman and bilateral lesions. And the translumlar LESS has an advantage on avoiding intestinal disturbances. All in all, the learning curve of LESS is long and the continuous technical improvement and more experience are needed.
何正宇, 杨峻峰, 余闫宏, 申杰, 肖龙. 泌尿外科经脐、经腰单孔腹腔镜手术的初步对比及技术(附166例报道)[J]. 微创泌尿外科杂志, 2017, 6(5): 271-274.
He Zhengyu, Yang Junfeng, Yu Yanhong, Shen Jie, Xiao Long. Comparative study between Umbilical Laparoendoscopic Single-site Surgery and Retroperitioneal Laparoendoscopic Single-site Surgery in urology (166 cases report). JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2017, 6(5): 271-274.
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