Abstrakt Technologie Srpen 2010

“Single-port in urology.”

Crouzet, S., G. P. Haber, et al. (2010).

Single-port en urologie.


Single-port transumbilical laparoscopy has emerged as an attempt to further enhance cosmetic benefits and reduce morbidity of minimally invasive surgery. Within a short span, several clinical reports have emerged in the urologic literature. As this field is poised to move forward, a complete understanding of its evolution and current status seems imperative. We have summarized and reviewed the history of Single-Port across surgical disciplines. This review emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Evidence acquisition: Using the National Library of Medicine database, the English language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, laparoendoscopic single site surgery intraumbilical, and transumbilical. Within the bibliography of selected references, additional sources were retrieved. Evidence synthesis: The major findings and surgical techniques described in these papers, are summarized in a chronological and subject-grouped manner. Conclusions: Single-port has made its initial forays into laparoscopic surgery. Ongoing refinement in technique and instrumentation is likely to expand its future role. © 2010 Elsevier Masson SAS. All rights reserved.




“Editorial: Single-port laparoscopy, NOTES, and endoluminal surgery.”

Escobar, P. F., J. H. Kaouk, et al. (2010).

Diagnostic and Therapeutic Endoscopy.




“Robotic Laparoendoscopic Single-Site Radical Prostatectomy: Technique and Early Outcomes.”

White, M. A., G. P. Haber, et al. (2010).

European Urology.


Background: Laparoendoscopic single-site (LESS) surgery is challenging. To help overcome current technical and ergonomic limitations, the da Vinci robotic platform can be applied to LESS. Objectives: Our aim was to describe the surgical technique and to report the early outcomes of robotic LESS (R-LESS) radical prostatectomy (RP). Design, setting, and participants: A retrospective review of prospectively captured R-LESS RP data was performed between May 2008 and May 2010. A total of 20 procedures were scheduled (12 with and 8 without pelvic lymph node dissection). Surgical procedure: R-LESS prostatectomy was performed using the methods outlined in the paper and in the supplemental video material. Interventions: All patients underwent R-LESS RP by one high-volume surgeon. Single-port access was achieved via a commercially available multichannel port. The da Vinci S and da Vinci Si surgical platform was used with pediatric and standard instruments. Measurements: Preoperative, perioperative, pathologic, and functional outcomes data were analyzed. Results and limitations: The mean age was 60.4 yr; body mass index was 25.4 kg/m<sup>2</sup>. The mean operative time was 189.5 min; estimated blood loss was 142.0 ml. The average length of stay was 2.7 d, and the visual analog pain score at discharge was 1.4 of 10. Four focal positive margins were encountered, with two occurring during the first three cases. Pathology revealed a Gleason score of 3 + 3 in 3 patients, 3 + 4 in 11 patients, 4 + 3 in 4 patients, and 4 + 4 in 2 patients. There were a total of four complications according to the Clavien system including one grade 1, two grade 2, and one grade 4. The median follow-up has been 4 mo (range: 1-24 mo). Study limitations include the small sample size, the short follow-up, and the lack of comparative cohort. Conclusions: The R-LESS RP is technically feasible and reduces some of the difficulties encountered with conventional LESS RP. © 2010 European Association of Urology.