Complications of Laparo-endoscopic Single-site Surgery in Urology

Overview

Journal Indian J Urol

Specialty Urology

Date 2013 Aug 20

PMID 23956509

Authors

Hagop Sarkissian

Brian H Irwin

Affiliations

Soon will be listed here.

Abstract

The objective was to give a general overview of common complications and rates reported in the current literature during performance of a variety of urologic procedures using laparo-endoscopic single-site surgery or LESS. A search of published reports using Pubmed and MEDLINE was performed with the following search terms: laparo-endoscopic single-site surgery, LESS or laparo-endoscopic single-site surgery complications within the date range of 2005--2011. Studies that were deemed appropriate and relevant to the current symposium were chosen for review. Overall complication rates were reported as ranging between 10% and 25%. In general, reconstructive procedures had consistently higher rates of complications than their extirpative/ablative counterparts (27% vs. 8%). There remain insufficient data to comment on differences in the rates or types of complications related to variations in the approach (transperitoneal vs. retroperitoneal), site of surgery (upper tract vs. lower tract) or specific technique used (instruments, access devices, robotic platforms, etc.). Complication rates associated with LESS in urology appear only slightly higher than with conventional laparoscopy. However, with proper patient selection and careful application of these techniques, proofs of concept and technical feasibility have been shown in several series. There continues to be a need for more standardization of the technique and reporting as well as more collaborative efforts to fully address questions of safety and efficacy of these new procedures.

References

White W, Haber G, Goel R, Crouzet S, Stein R, Kaouk J . Single-port urological surgery: single-center experience with the first 100 cases. Urology. 2009; 74(4):801-4. DOI: 10.1016/j.urology.2009.04.030. View

Seo I, Lee J, Rim J . Laparoendoscopic single-site radical nephrectomy: a comparison with conventional laparoscopy. J Endourol. 2011; 25(3):465-9. DOI: 10.1089/end.2010.0465. View

Raman J, Bensalah K, Bagrodia A, Stern J, Cadeddu J . Laboratory and clinical development of single keyhole umbilical nephrectomy. Urology. 2007; 70(6):1039-42. DOI: 10.1016/j.urology.2007.10.001. View

Stolzenburg J, Kallidonis P, Hellawell G, Do M, Haefner T, Dietel A . Technique of laparoscopic-endoscopic single-site surgery radical nephrectomy. Eur Urol. 2009; 56(4):644-50. DOI: 10.1016/j.eururo.2009.06.022. View

Kaouk J, Autorino R, Kim F, Han D, Lee S, Yinghao S . Laparoendoscopic single-site surgery in urology: worldwide multi-institutional analysis of 1076 cases. Eur Urol. 2011; 60(5):998-1005. DOI: 10.1016/j.eururo.2011.06.002. View

Aron M, Canes D, Desai M, Haber G, Kaouk J, Gill I . Transumbilical single-port laparoscopic partial nephrectomy. BJU Int. 2008; 103(4):516-21. DOI: 10.1111/j.1464-410X.2008.08007.x. View

Kurien A, Rajapurkar S, Sinha L, Mishra S, Ganpule A, Muthu V . First prize: Standard laparoscopic donor nephrectomy versus laparoendoscopic single-site donor nephrectomy: a randomized comparative study. J Endourol. 2011; 25(3):365-70. DOI: 10.1089/end.2010.0250. View

Desai M, Berger A, Brandina R, Aron M, Irwin B, Canes D . Laparoendoscopic single-site surgery: initial hundred patients. Urology. 2009; 74(4):805-12. DOI: 10.1016/j.urology.2009.02.083. View

Best S, Donnally C, Mir S, Tracy C, Raman J, Cadeddu J . Complications during the initial experience with laparoendoscopic single-site pyeloplasty. BJU Int. 2011; 108(8):1326-9. DOI: 10.1111/j.1464-410X.2011.10078.x. View

10.

Irwin B, Cadeddu J, Tracy C, Kim F, Molina W, Rane A . Complications and conversions of upper tract urological laparoendoscopic single-site surgery (LESS): multicentre experience: results from the NOTES Working Group. BJU Int. 2010; 107(8):1284-9. DOI: 10.1111/j.1464-410X.2010.09663.x. View

11.

Choi K, Ham W, Rha K, Lee J, Jeon H, Arkoncel F . Laparoendoscopic single-site surgeries: a single-center experience of 171 consecutive cases. Korean J Urol. 2011; 52(1):31-8. PMC: 3037504. DOI: 10.4111/kju.2011.52.1.31. View

12.

Afaneh C, Aull M, Gimenez E, Wang G, Charlton M, Leeser D . Comparison of laparoendoscopic single-site donor nephrectomy and conventional laparoscopic donor nephrectomy: donor and recipient outcomes. Urology. 2011; 78(6):1332-7. DOI: 10.1016/j.urology.2011.04.077. View

13.

Lee J, Arkoncel F, Rha K, Choi K, Yu H, Chae Y . Urologic robot-assisted laparoendoscopic single-site surgery using a homemade single-port device: a single-center experience of 68 cases. J Endourol. 2011; 25(9):1481-5. DOI: 10.1089/end.2010.0656. View

14.

Gill I, Advincula A, Aron M, Caddedu J, Canes D, Curcillo 2nd P . Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc. 2009; 24(4):762-8. DOI: 10.1007/s00464-009-0688-8. View

15.

Greco F, Cindolo L, Autorino R, Micali S, Stein R, Bianchi G . Laparoendoscopic single-site upper urinary tract surgery: assessment of postoperative complications and analysis of risk factors. Eur Urol. 2011; 61(3):510-6. DOI: 10.1016/j.eururo.2011.08.032. View

16.

Mir S, Best S, Donnally 3rd C, Gurbuz C, Tracy C, Raman J . Minimally invasive nephrectomy: the influence of laparoendoscopic single-site surgery on patient selection, outcomes, and morbidity. Urology. 2010; 77(3):631-4. DOI: 10.1016/j.urology.2010.06.063. View

17.

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

18.

Kaouk J, Goel R, Haber G, Crouzet S, Desai M, Gill I . Single-port laparoscopic radical prostatectomy. Urology. 2008; 72(6):1190-3. DOI: 10.1016/j.urology.2008.06.010. View

19.

Rais-Bahrami S, Montag S, Atalla M, Andonian S, Kavoussi L, Richstone L . Laparoendoscopic single-site surgery of the kidney with no accessory trocars: an initial experience. J Endourol. 2009; 23(8):1319-24. DOI: 10.1089/end.2009.0065. View