Laparo-Endoscopic Single Site (LESS) Management of Benign Kidney Diseases: Evaluation of Complications
Sompol Permpongkosol MD, PhD*, Pokket Ungbhakorn MD*, Charoen Leenanupunth MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : To present our experience with Laparo-Endoscopic Single Site (LESS) management of benign kidney diseases.
Material and Method: Between September 2008 and November 2009, 18 patients underwent single port transumbilical
laparoscopic surgery for nephrectomy for a nonfunctioning kidney (7 cases), cyst decortications for symptomatic renal cyst
(10 cases), and redo-dismembered pyeloplasty with previously failed laparoscopic surgical repair (1 case). Patients underwent
surgery through a single 2-cm infraumbilical incision with the triport laparoscopic-port. All pathological reports of LESS
nephrectomy and cyst decortications confirmed with chronic pyelonephritis and simple cysts, respectively. Histology of
xanthogranulomotus pyelonephritis showed two cases of the nephrectomy procedure.
Results : Mean patient age and BMI were 61 + SD 14.2 years and 24.75 + SD 11.2 kg/m2, respectively. Mean operating time
was 187.7 + SD 71.4 min. LESS was a possible and safe approach in 77.8% of patients. All LESS cyst decortications and
redo-pyeloplasty were completed without major complications or conversion to open surgery. However, there was one case
each of LESS cyst decortication and pyeloplasty requiring an additional 3-mm port for suturing due to bleeding and an
instrument error. For LESS nephrectomy, two (28.6%) with higher waist circumference were converted to standard laparoscopic
nephrectomy due to failure to progress. One post operative complication of incisional hernia occurred in a patient with
chronic bronchitis and asthma.
Conclusion : LESS for the management of benign kidney diseases is an effective and safe treatment option with selected
patients and experienced surgeon.
Keywords : Laparo-endoscopic single site (LESS), Laparoscopy, Benign, Kidney disease, Renal cysts, Redo-pyeloplasty
