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Original ArticleOpen Access
Laparo-Endoscopic Single Site (LESS) Management of Benign Kidney Diseases: Evaluation of Complications
Permpongkosol S 
,
Ungbhakorn P ,
Leenanupunth C
,
Ungbhakorn P ,
Leenanupunth C 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 transumbilicallaparoscopic 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 underwentsurgery through a single 2-cm infraumbilical incision with the triport laparoscopic-port. All pathological reports of LESSnephrectomy and cyst decortications confirmed with chronic pyelonephritis and simple cysts, respectively. Histology ofxanthogranulomotus 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 timewas 187.7 + SD 71.4 min. LESS was a possible and safe approach in 77.8% of patients. All LESS cyst decortications andredo-pyeloplasty were completed without major complications or conversion to open surgery. However, there was one caseeach of LESS cyst decortication and pyeloplasty requiring an additional 3-mm port for suturing due to bleeding and aninstrument error. For LESS nephrectomy, two (28.6%) with higher waist circumference were converted to standard laparoscopicnephrectomy due to failure to progress. One post operative complication of incisional hernia occurred in a patient withchronic bronchitis and asthma.
Conclusion: LESS for the management of benign kidney diseases is an effective and safe treatment option with selectedpatients and experienced surgeon.
Keywords: Laparo-endoscopic single site (LESS), Laparoscopy, Benign, Kidney disease, Renal cysts, Redo-pyeloplasty
Material and Method: Between September 2008 and November 2009, 18 patients underwent single port transumbilicallaparoscopic 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 underwentsurgery through a single 2-cm infraumbilical incision with the triport laparoscopic-port. All pathological reports of LESSnephrectomy and cyst decortications confirmed with chronic pyelonephritis and simple cysts, respectively. Histology ofxanthogranulomotus 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 timewas 187.7 + SD 71.4 min. LESS was a possible and safe approach in 77.8% of patients. All LESS cyst decortications andredo-pyeloplasty were completed without major complications or conversion to open surgery. However, there was one caseeach of LESS cyst decortication and pyeloplasty requiring an additional 3-mm port for suturing due to bleeding and aninstrument error. For LESS nephrectomy, two (28.6%) with higher waist circumference were converted to standard laparoscopicnephrectomy due to failure to progress. One post operative complication of incisional hernia occurred in a patient withchronic bronchitis and asthma.
Conclusion: LESS for the management of benign kidney diseases is an effective and safe treatment option with selectedpatients and experienced surgeon.
Keywords: Laparo-endoscopic single site (LESS), Laparoscopy, Benign, Kidney disease, Renal cysts, Redo-pyeloplasty
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