Laparoendoscopic single-site surgery: early experience with tumor nephrectomy.

Background And Purpose: Laparoendoscopic single-site surgery (LESS) represents the closest surgical technique to scar-free surgery. We performed LESS for renal tumor nephrectomy in eight patients to assess feasibility and perioperative outcome.

Patients And Methods: Eight patients with a body mass index (BMI)
Results: All LESS nephrectomy operations were successfully accomplished without the need to convert to conventional laparoscopy. The median patient age was 60.75 years (range 22-76 years) and median BMI was 22.95 (range 18.2-26.1). The median operative duration was 141 minutes (range 120-180 min), and the median blood loss was 103 mL (range 50-150 mL). Histologic evaluation confirmed complete excision of an intact specimen. All cases revealed organ-confined T(1) renal-cell carcinoma (two right-sided and six left-sided, tumor diameter range 4-8 cm). A tumor with an adjacent simple renal cyst was excised in one patient. No intraoperative or postoperative complications occurred.

Conclusions: LESS was a feasible and safe approach in a selected group of patients (low BMI and stage tumor). LESS nephrectomy was made possible with the use of multi-instrument port and flexible instruments. The oncologic outcome was not compromised. Further evaluation of LESS surgery needs prospective, randomized studies.