Case Series of the MonthSPIDER Surgical System for Urologic Procedures With Laparoendoscopic Single-Site Surgery: From Initial Laboratory Experience to First Clinical Application
Section snippets
Case series
Early comparative studies have suggested that laparoendoscopic single-site surgery (LESS) is not inferior to laparoscopy in terms of perioperative outcomes and has the potential advantage of reduced surgical trauma [1], [2]. To overcome technical limitations related to ergonomics during LESS, new-generation purpose-built platforms and instruments are being developed [3]. Moreover, the application of robotic technology is being proposed to further minimize the limitations of LESS [4], [5].
Dry lab
Mean time to complete the peg transfer task was 225.2 ± 42 s, with one registered penalty in four cases. In all cases, surgeons were able to perform the task within the cutoff time limit. The mean time to complete the pattern cutting task was 245.3 ± 45.7 s, with one registered penalty in six cases. Two surgeons had two penalties, and other two had one penalty each. In all cases, surgeons were able to perform the task within the cutoff time limit. The mean time to complete the suturing task was 453.8 ±
Discussion
Groups pioneering the LESS technique showed the clinical application of different multichannel platforms, including the TriPort (Olympus, Tokyo, Japan) [10], SILS (Covidien) [11], GelPOINT or GelPort (Applied Medical) [12], [13], and X-CONE (Karl Storz, Tuttlingen, Germany) laparoscopy ports [14]. Each device presents specific features aiming to facilitate LESS. However, the ideal platform and instrumentation are yet to be defined, and optimal intraoperative ergonomics during LESS continues to
Conflicts of interest
The authors have nothing to disclose.
Funding support: This study was supported by a grant from TransEnterix.
EU-ACME questions
Please visit www.eu-acme.org/europeanurology to answer the following EU-ACME questions online (the EU-ACME credits will be attributed automatically).
Questions:
- 1.
Among the features of laparoendoscopic single-site surgery (LESS) versus standard multiport laparoscopy is:
- A.
Need of a flexible scope
- B.
Lack of triangulation
- C.
Application for upper urinary tract procedures only
- D.
None of the above
- 2.
The SPIDER platform is designed to allow:
- A.
Multiple surgical instruments to be manipulated through a single port
- B.
References (15)
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Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison
Eur Urol
(2010) - et al.
Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence
Eur Urol
(2009) - et al.
Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology: a critical analysis of the literature
Eur Urol
(2011) - et al.
Novel robotic daVinci instruments for laparoendoscopic single-site surgery
Urology
(2010) - et al.
Robotic partial nephrectomy with sliding-clip renorrhaphy: technique and outcomes
Eur Urol
(2009) - et al.
Technique of laparoscopic-endoscopic single-site surgery radical nephrectomy
Eur Urol
(2009) - et al.
Robotic laparoendoscopic single-site radical prostatectomy: technique and early outcomes
Eur Urol
(2010)
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- 1
These authors contributed equally.