La néphrectomie laparoscopique par accès ombilical unique : évolution ou révolution chirurgicale ? [Renal LESS surgery: Slight modification or surgical revolution?]. - Archive ouverte HAL Access content directly
Journal Articles Progrès en Urologie Year : 2011

La néphrectomie laparoscopique par accès ombilical unique : évolution ou révolution chirurgicale ? [Renal LESS surgery: Slight modification or surgical revolution?].

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Abstract

OBJECTIVE: to present our initial experience of laparoendoscopic single site (LESS) renal surgery. METHODS: between May 2009 and March 2010, nine nephrectomies and one cyst decortication were performed in nine patients. Eight of the procedures were done with three 5mm trocars inserted through a unique peri-umbilical incision. In two cases, a specific single-port device was used. All operations were achieved with a 5-mm 30° lens and conventional laparoscopic instruments. The specimens were entrapped in a 10mm endoscopic bag and extracted through the umbilical incision. RESULTS: mean age was 56 years old. Mean BMI was 23.5 [19-34]. Mean operative time was 149min [80-240], and estimated blood loss was 90ml [20-250]. None of the patients required blood transfusion. Mean length of stay was 4.1 days [3-5]. Only one major complication occurred (functional occlusion). One conversion to conventional laparoscopy was necessary in a case of inflammatory kidney. Histologic exam showed benign lesions (cyst and non functional kidney) in seven cases, and papillary carcinoma in three cases. CONCLUSION: LESS surgery is feasible. Its advantages over conventional laparoscopy are not clear. LESS is a new procedure that should benefit from the improvement of technical instrumentation.
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Dates and versions

inserm-00593488 , version 1 (16-05-2011)

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Gregory Verhoest, Jean-Jacques Patard, Arnaud Delreux, Maxime Crépel, Andréa Manunta, et al.. La néphrectomie laparoscopique par accès ombilical unique : évolution ou révolution chirurgicale ? [Renal LESS surgery: Slight modification or surgical revolution?].. Progrès en Urologie, 2011, 21 (1), pp.29-33. ⟨10.1016/j.purol.2010.08.008⟩. ⟨inserm-00593488⟩
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