Laparo-endoscopic single site (LESS) management of benign kidney diseases: Evaluation of complications

Abstract

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/m 2 , 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.