Laparoendoscopic single-site radical nephrectomy for renal cancer: technique and surgical outcomes.

Abstract

Objective: To describe the technique and report the surgical outcomes of 33 LESS radical nephrectomies (LESS-RN) in the treatment of renal cell carcinoma(RCC).
Methods: The indications to perform a LESS-RN were represented by T2 renal tumors or lower without evidence of lymphadenopathy or renal vein involvement. Demographic data and perioperative and postoperative variables were recorded and analysed.
The Endocone (Karl Storz, Tuttlingen, Germany) was inserted through a transumbilical incision. A combination of standard laparoscopic instruments and bent grasper and scissors was used. The sequence of steps of LESS-RN was comparable to standard laparoscopic radical nephrectomy.
Results: The mean operative time was 143.7±24.3 min, with a mean EBL of 122.3±34.1 ml and a mean hospital stay resulted to be 3.8±0.8. The mean length of skin incision was 4.1±0.6 cm and all patients were discharged with minimal discomfort, as demonstrated by their VAS score (1.9 ±0.8). Final pathology revealed RCC in all cases (4 T1a, 27 T1b and 2 T2). At a median follow-up period of 13.2±3.9 months, all patients were alive and disease free.
Conclusions: LESS-RN is a safe and feasible surgical procedure for radical nephrectomy in the treatment of RCC, with excellent cosmetic results.