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Erschienen in: Surgical Endoscopy 4/2011

01.04.2011

Laparoendoscopic single-site (LESS) retroperitoneal adrenalectomy using a homemade single-access platform and standard laparoscopic instruments

verfasst von: Shiu-Dong Chung, Chao-Yuan Huang, Shuo-Meng Wang, Huai-Ching Tai, Yao-Chou Tsai, Shih-Chieh Chueh

Erschienen in: Surgical Endoscopy | Ausgabe 4/2011

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Abstract

Background

This study aimed to evaluate laparoendoscopic single-site (LESS) adrenalectomy via the retroperitoneal approach using the Alexis wound retractor with standard laparoscopic instrumentation.

Methods

Since October 2009, seven LESS retroperitoneal adrenalectomies have been completed successfully with a homemade single port created using an Alexis wound retractor as an access platform through a 3-cm incision beneath the tip of the 12th rib.

Results

All the LESS procedures for these seven patients with adrenal tumors (size, 1.3–6.0 cm; 4 right, 1 left) were completed successfully without traditional laparoscopic conversion or complication. The average operative time was 159 min, and the estimated blood loss was 100 ml. The average hospital stay was 2 days (range, 1–3 days).

Conclusions

The preliminary results show that LESS retroperitoneal adrenalectomy is a safe and feasible procedure for functional adrenal tumors using standard laparoscopic instruments.
Literatur
1.
Zurück zum Zitat Stolzenburg J-U, Kallidonis P, Till H, Burchardt M, Herrmann TR, Liatsikos EN (2009) Current status of laparoendoscopic single-site surgery in urology. World J Urol 27:767–773 CrossRef Stolzenburg J-U, Kallidonis P, Till H, Burchardt M, Herrmann TR, Liatsikos EN (2009) Current status of laparoendoscopic single-site surgery in urology. World J Urol 27:767–773 CrossRef
2.
Zurück zum Zitat Liatsikos E, Kallidonis P, Kyriazis I, Al-Aown A, Stolzenburg JU (2009) Urologic laparoendoscopic single-site surgery. Nat Rev Urol 6:654–659 PubMedCrossRef Liatsikos E, Kallidonis P, Kyriazis I, Al-Aown A, Stolzenburg JU (2009) Urologic laparoendoscopic single-site surgery. Nat Rev Urol 6:654–659 PubMedCrossRef
4.
Zurück zum Zitat Marescaux J, Mutter D, Wheeler MH (1996) Laparoscopic right and left adrenalectomies: surgical procedures. Surg Endosc 10:912–915 PubMedCrossRef Marescaux J, Mutter D, Wheeler MH (1996) Laparoscopic right and left adrenalectomies: surgical procedures. Surg Endosc 10:912–915 PubMedCrossRef
5.
Zurück zum Zitat Walz MK, Alesina PF, Wenger FA, Deligiannis A, Szuczik E, Petersenn S, Ommer A, Groeben H, Peitgen K, Janssen OE, Philipp T, Neumann HP, Schmid KW, Mann K (2006) Posterior retroperitoneoscopic adrenalectomy: results of 560 procedures in 520 patients. Surgery 140:943–948 PubMedCrossRef Walz MK, Alesina PF, Wenger FA, Deligiannis A, Szuczik E, Petersenn S, Ommer A, Groeben H, Peitgen K, Janssen OE, Philipp T, Neumann HP, Schmid KW, Mann K (2006) Posterior retroperitoneoscopic adrenalectomy: results of 560 procedures in 520 patients. Surgery 140:943–948 PubMedCrossRef
6.
Zurück zum Zitat Eisenberg MS, Cadeddu JA, Desai MM (2010) Laparoendoscopic single-site surgery in urology. Curr Opin Urol 20:141–147 PubMedCrossRef Eisenberg MS, Cadeddu JA, Desai MM (2010) Laparoendoscopic single-site surgery in urology. Curr Opin Urol 20:141–147 PubMedCrossRef
7.
Zurück zum Zitat Raman JD, Bensalah K, Bagrodia A, Stern JM, Cadeddu JA (2007) Laboratory and clinical development of single keyhole umbilical nephrectomy. Urology 70:1039–1042 PubMedCrossRef Raman JD, Bensalah K, Bagrodia A, Stern JM, Cadeddu JA (2007) Laboratory and clinical development of single keyhole umbilical nephrectomy. Urology 70:1039–1042 PubMedCrossRef
8.
Zurück zum Zitat Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6 PubMedCrossRef Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6 PubMedCrossRef
9.
Zurück zum Zitat Desai MM, Rao PP, Aron M, Pascal-Haber G, Desai MR, Mishra S, Kaouk JH, Gill IS (2008) Scarless single-port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int 101:83–88 PubMedCrossRef Desai MM, Rao PP, Aron M, Pascal-Haber G, Desai MR, Mishra S, Kaouk JH, Gill IS (2008) Scarless single-port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int 101:83–88 PubMedCrossRef
10.
Zurück zum Zitat Kaouk JH, Palmer JS (2008) Single-port laparoscopic surgery: initial experience in children for varicocelectomy. BJU Int 102:97–99 PubMedCrossRef Kaouk JH, Palmer JS (2008) Single-port laparoscopic surgery: initial experience in children for varicocelectomy. BJU Int 102:97–99 PubMedCrossRef
11.
Zurück zum Zitat Rané A, Rao P, Rao P (2008) Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). Urology 72:260–263 PubMedCrossRef Rané A, Rao P, Rao P (2008) Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). Urology 72:260–263 PubMedCrossRef
12.
Zurück zum Zitat Gill IS, Canes D, Aron M, Haber GP, Goldfarb DA, Flechner S, Desai MR, Kaouk JH, Desai MM (2008) Single-port transumbilical (E-NOTES) donor nephrectomy. J Urol 180:637–641 PubMedCrossRef Gill IS, Canes D, Aron M, Haber GP, Goldfarb DA, Flechner S, Desai MR, Kaouk JH, Desai MM (2008) Single-port transumbilical (E-NOTES) donor nephrectomy. J Urol 180:637–641 PubMedCrossRef
13.
Zurück zum Zitat Castellucci SA, Curcillo PG, Ginsberg PC, Saba SC, Jaffe JS, Harmon JD (2008) Single-port access adrenalectomy. J Endourol 22:1573–1576 PubMedCrossRef Castellucci SA, Curcillo PG, Ginsberg PC, Saba SC, Jaffe JS, Harmon JD (2008) Single-port access adrenalectomy. J Endourol 22:1573–1576 PubMedCrossRef
14.
Zurück zum Zitat Raman JD, Bagrodia A, Cadeddu JA (2009) Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol 55:1198–1206 PubMedCrossRef Raman JD, Bagrodia A, Cadeddu JA (2009) Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence. Eur Urol 55:1198–1206 PubMedCrossRef
15.
Zurück zum Zitat Aron M, Canes D, Desai MM, Haber GP, Kaouk JH, Gill IS (2009) Transumbilical single-port laparoscopic partial nephrectomy. BJU Int 103:516–521 PubMedCrossRef Aron M, Canes D, Desai MM, Haber GP, Kaouk JH, Gill IS (2009) Transumbilical single-port laparoscopic partial nephrectomy. BJU Int 103:516–521 PubMedCrossRef
16.
Zurück zum Zitat White WM, Haber GP, Goel RK, Crouzet S, Stein RJ, Kaouk JH (2009) Single-port urological surgery: single-center experience with the first 100 cases. Urology 74:801–804 PubMedCrossRef White WM, Haber GP, Goel RK, Crouzet S, Stein RJ, Kaouk JH (2009) Single-port urological surgery: single-center experience with the first 100 cases. Urology 74:801–804 PubMedCrossRef
17.
Zurück zum Zitat Walz MK, Groeben H, Alesina PF (2010) Single-access retroperitoneoscopic adrenalectomy (SARA) versus conventional retroperitoneoscopic adrenalectomy (CORA): a case-control study. World J Surg 34:1386–1390 PubMedCrossRef Walz MK, Groeben H, Alesina PF (2010) Single-access retroperitoneoscopic adrenalectomy (SARA) versus conventional retroperitoneoscopic adrenalectomy (CORA): a case-control study. World J Surg 34:1386–1390 PubMedCrossRef
18.
Zurück zum Zitat Tracy CR, Raman JD, Cadeddu JA, Rane A (2008) Laparoendoscopic single-site surgery in urology: where have we been and where are we heading? Nat Clin Pract Urol 5:561–568 PubMedCrossRef Tracy CR, Raman JD, Cadeddu JA, Rane A (2008) Laparoendoscopic single-site surgery in urology: where have we been and where are we heading? Nat Clin Pract Urol 5:561–568 PubMedCrossRef
19.
Zurück zum Zitat Stein RJ, White WM, Goel RK, Irwin BH, Haber GP, Kaouk JH (2010) Robotic laparoendoscopic single-site surgery using GelPort as the access platform. Eur Urol 57:132–136 PubMedCrossRef Stein RJ, White WM, Goel RK, Irwin BH, Haber GP, Kaouk JH (2010) Robotic laparoendoscopic single-site surgery using GelPort as the access platform. Eur Urol 57:132–136 PubMedCrossRef
20.
Zurück zum Zitat Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, Ishida H, Takimoto Y, Saitoh T, Kiyotaki S, Okada K (2005) Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol 19:788–792 PubMedCrossRef Hirano D, Minei S, Yamaguchi K, Yoshikawa T, Hachiya T, Yoshida T, Ishida H, Takimoto Y, Saitoh T, Kiyotaki S, Okada K (2005) Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port. J Endourol 19:788–792 PubMedCrossRef
21.
Zurück zum Zitat Walz MK, Alesina PF (2009) Single-access retroperitoneoscopic adrenalectomy (SARA): one step beyond in endocrine surgery. Langenbecks Arch Surg 394:447–450 PubMedCrossRef Walz MK, Alesina PF (2009) Single-access retroperitoneoscopic adrenalectomy (SARA): one step beyond in endocrine surgery. Langenbecks Arch Surg 394:447–450 PubMedCrossRef
22.
Zurück zum Zitat Jeon HG, Jeong W, Oh CK, Lorenzo EI, Ham WS, Rha KH, Han WK (2010) Initial experience with 50 laparoendoscopic single-site surgeries using a homemade, single port device at a single center. J Urol 183:1866–1871 PubMedCrossRef Jeon HG, Jeong W, Oh CK, Lorenzo EI, Ham WS, Rha KH, Han WK (2010) Initial experience with 50 laparoendoscopic single-site surgeries using a homemade, single port device at a single center. J Urol 183:1866–1871 PubMedCrossRef
23.
Zurück zum Zitat Tai HC, Lin CD, Wu CC, Tsai YC, Yang SS (2010) Homemade transumbilical port: an alternative access for laparoendoscopic single-site surgery (LESS). Surg Endosc 24:705–708 PubMedCrossRef Tai HC, Lin CD, Wu CC, Tsai YC, Yang SS (2010) Homemade transumbilical port: an alternative access for laparoendoscopic single-site surgery (LESS). Surg Endosc 24:705–708 PubMedCrossRef
Metadaten
Titel
Laparoendoscopic single-site (LESS) retroperitoneal adrenalectomy using a homemade single-access platform and standard laparoscopic instruments
verfasst von
Shiu-Dong Chung
Chao-Yuan Huang
Shuo-Meng Wang
Huai-Ching Tai
Yao-Chou Tsai
Shih-Chieh Chueh
Publikationsdatum
01.04.2011
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 4/2011
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1352-z