Abstract:

Single-incision laparoscopic surgery (SILS) is a recent development in minimally invasive surgery. This is an initial SILS experience in reconstructive urology to prove feasibility and provide a comparison with conventional laparoscopy during perioperative and convalescent periods. A single surgeon performed two complex SILS operations (psoas bladder hitch with Boari flap for high ureteric stricture [SILS-PB] and nephropexy for severe nephroptosis [SILS-Np]). A group of 6 patients with previous experience with conventional laparoscopy by the same surgeon with the same operation complexity was selected for retrospective comparison. SILS was performed through multichannel port (intraumbilical or retroperitoneal). There was no conversion to laparoscopy. Operative time (Or-t) was 365 and 185 minutes for SILS-PB and SILS-Np, respectively. Blood loss was 100 ml for SILS-PB without any intraoperative complications. Baseline demographics, Or-t, blood loss, and hospital stay were comparable to the laparoscopic group. Except for prolonged Or-t, patients undergoing SILS had similar surgical outcomes and comparable convalescent periods. Follow-up was uneventful for both groups. Patients' global satisfaction and willingness to recommend their procedure to others were favorable and equivalent between groups. Thus, SILS-reconstructive operations for high ureteric strictures and severe nephroptosis are feasible. It seems equally as efficacious as conventional laparoscopy maintaining surgical standards without differences in perioperative outcomes and convalescence.

Authors:

Wael Y. Khoder, MD, MSc, Senior Staff Urologist, Department of Urology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany, Boris, Schlenker, MD, Senior Urologist, Department of Urology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany, Matthias Trottmann, MD, Senior Urologist, Department of Urology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany, Christian G Stief, MD, PhD, Professor and Chairman, Department of Urology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany, Armin J Becker, MD, Senior, Staff Urologist, Department of Urology, University Hospital Munich-Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany

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