Laparoendoscopic single-site surgery for nephrectomy as a feasible alternative to traditional laparoscopy.

Raybourn, James H; Rane, Abhay; Sundaram, Chandru P

OBJECTIVES To report an initial clinical urologic experience using single-port surgery compared to the traditional laparoscopic technique for nephrectomy. METHODS A total of 11 patients underwent laparoscopic nephrectomy using the laparoendoscopic single-site surgery (LESS) procedure, with 1 R-port used for each. A group of 10 patients who previously underwent simple nephrectomies by 1 of the 2 surgeons were selected for comparison. The intraoperative and postoperative narcotic analgesia requirements were compared between the 2 groups. The Student t test was used to compare the means. All complications, clinical data, and technical issues with performing the procedure were noted. RESULTS All LESS simple nephrectomy procedures were completed uneventfully. There were no intraoperative complications in the LESS group. Postoperative complications included pyrexia and port site bruising with 2 patients. Operative time showed no significant difference in the LESS group compared to the traditional laparoscopic group (151 vs 165 minutes). Narcotic analgesia requirements showed no significant difference in both intraoperative and postoperative usage analyses (P = .15 and P = .55, respectively). CONCLUSIONS The LESS technique can be performed safely compared to traditional laparoscopy. With no significant difference in operative time and relatively few complications, this is a feasible technique for simple nephrectomy. Even though there is no significant difference in intraoperative and immediate postoperative narcotic usage, the procedure has obvious cosmetic advantages.