899 ROBOTIC LAPAROENDOSCOPIC SINGLE-SITE (R-LESS) SURGERY: SINGLE CENTER CUMULATIVE EXPERIENCE (2010)

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy II1 Apr 2010899 ROBOTIC LAPAROENDOSCOPIC SINGLE-SITE (R-LESS) SURGERY: SINGLE CENTER CUMULATIVE EXPERIENCE Michael A. White, Georges-Pascal Haber, Riccardo Autorino, Rakesh Khanna, Sylvain Forest, Robert J. Stein, and Jihad H. Kaouk Michael A. WhiteMichael A. White More articles by this author , Georges-Pascal HaberGeorges-Pascal Haber More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , Rakesh KhannaRakesh Khanna More articles by this author , Sylvain ForestSylvain Forest More articles by this author , Robert J. SteinRobert J. Stein More articles by this author , and Jihad H. KaoukJihad H. Kaouk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1655AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To further decrease the morbidity of standard laparoscopy, newer techniques such as LaparoEndoscopic Single-Site (LESS) surgery are currently being investigated. LESS surgery is technically challenging and requires both an experienced laparoscopic surgeon and assistant. To help overcome current limitations we have introduced the daVinci surgical system to LESS and report our cumulative experience with robotic laparoendoscopic single-site (R-LESS) surgery. METHODS A retrospective review of R-LESS surgery was performed. Salient demographic and operative data were obtained. End-points including age, Body Mass Index (BMI), operative time, estimated blood loss (EBL), complications, conversion, and length of stay (LOS) were examined. Single port access was achieved via a commercially available multi-channel port. The daVinci-S® surgical platform using pediatric instruments were used. RESULTS Between May 2008 and October 2009 a total of 18 R-LESS procedures were performed (upper tract, 7 and pelvic, 11). These procedures included: pyeloplasty, 2, radical nephrectomy, 2, partial nephrectomy, 3, nephro-ureterectomy, 2, sacrocolpopexy, 1, radical cystectomy, 1, and radical prostatectomy, 7. A nephro-ureterectomy had to be converted to pure laparoscopy due to inadequate length of robotic instruments. A rectal injury occurred in the radical cystectomy, was recognized intra-operatively, and closed primarily without sequelae. All margins were negative for the upper tract surgeries while 2/11 pelvic surgeries had focally positive margins. These occurred in the first two radical prostatectomies. CONCLUSIONS By introducing the da Vinci robotic system to LESS we hope to further diminish the impediments that limit this minimally invasive technique. Prospective studies are needed but preliminary results are encouraging. Cleveland, OH© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e351-e352 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael A. White More articles by this author Georges-Pascal Haber More articles by this author Riccardo Autorino More articles by this author Rakesh Khanna More articles by this author Sylvain Forest More articles by this author Robert J. Stein More articles by this author Jihad H. Kaouk More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...