Initial operative experience of single-port retroperitoneal laparoscopic nephrectomy.

Okegawa, Takatsugu; Itaya, Naoshi; Hara, Hidehiko; Nutahara, Kikuo; Higashihara, Eiji

This paper reports our early experience with single-port laparoscopic nephrectomy via the retroperitoneal approach. Since April 2010, 23 patients have undergone single-port laparoscopic surgery for simple nephrectomy (n = 11 patients) and radical nephrectomy (n = 12) by an experienced laparoscopic surgeon. The mean operative time was 265.2 min and the mean estimated blood loss was 96.7 mL. The procedure was completed in all patients without conversion to standard laparoscopy or open surgery. No intraoperative or acute postoperative complications occurred. When the single-port retroperitoneal laparoscopic nephrectomy group was retrospectively compared with the group that had undergone standard retroperitoneal laparoscopic nephrectomy, no significant difference was noted with respect to age, body mass index, operation time, time to eat, catheter removal or length of hospitalization (P > 0.05). A significant difference in favor of the single-port retroperitoneal laparoscopic nephrectomy group was noted with respect to the estimated blood loss (P = 0.027) and the visual analog pain scale score at discharge (P = 0.016). Although our findings show that retroperitoneal single-port laparoscopic nephrectomy is feasible with advanced techniques and optimal instrumentation, further study is required to determine the future extent of its clinical application.