scholarly journals Laparoendoscopic Single-Site (LESS) Surgery in Pediatric Urology: A 4-Year Experience

2018 ◽  
Vol 12 (3) ◽  
pp. 153-157 ◽  
Author(s):  
Mohamed Zouari ◽  
Mahdi Ben Dhaou ◽  
Saloua Ammar ◽  
Mohamed Jallouli ◽  
Riadh Mhiri
Keyword(s):  
Single Site ◽  
Testicular Atrophy ◽  
Entire Cohort ◽  
Laparoendoscopic Single Site ◽  
Laparoscopic Instruments ◽  
Safe Technique ◽  
The Mean ◽  
Glove Port ◽  
Median Operative Time

Objective: The aim of the study was to assess the feasibility and outcomes of pediatric urological laparoendoscopic single-site (LESS) surgery. Materials and Methods: We retrospectively collected charts of all patients who underwent LESS procedures in our department from January 2013 to December 2016. Data included demographic characteristics, type of procedures, intraoperative details, hospital stay, and complications. The umbilicus was used as the surgical site in all cases. All procedures were performed with a homemade glove port and standard straight 3- or 5-mm laparoscopic instruments. Results: Seventy-three patients (55 males, 18 females) were identifed. Procedures included 46 orchidop-exies, 21 pyeloplasties, 8 varicocelectomies, 3 nephrecto-mies, 3 nephroureterectomies, 3 orchiectomies, and 1 renal hydatid cyst treatment. Median operative time for the entire cohort was 47 min (range 26-156 min). There was no signifcant intraoperative blood loss. No conversion to conventional laparoscopy or open surgery was needed. All patients required paracetamol postoperatively. The mean follow-up was 18 months. Two patients had testicular atrophy after a Fowler-Stephens procedure and 1 patient had testicular reascension. Cosmetic results were excellent. Forty-five (62.5%) patients were discharged on the day of surgery. Conclusion: Our study demonstrated that LESS surgery using our glove port technique and conventional laparoscopic instruments is a feasible and safe technique for the surgical management of various pediatric urological conditions.

Our Experience with Retroperitoneal Laparoendoscopic Single-Site Ureterolithotomy

2014 ◽  
Vol 94 (1) ◽  
pp. 58-63
Author(s):  
Zhonghua Wu ◽  
Youming Xu ◽  
Jianhua Yu ◽  
Jin Liu ◽  
Jiushun Chen ◽  
...  
Keyword(s):  
Single Port ◽  
Intraoperative Complications ◽  
Single Site ◽  
Ureteral Stones ◽  
Laparoendoscopic Single Site ◽  
Laparoscopic Instruments ◽  
Costal Arch ◽  
Attractive Option ◽  
The Mean ◽  
Port Device

Aim: To report our experience with retroperitoneal laparoendoscopic single-site (LESS) ureterolithotomy for the management of large proximal ureteral stones. Patients and Methods: From July 2011 to April 2012, 20 patients underwent retroperitoneal LESS ureterolithotomy. The indications for the operation were impacted upper ureteral stones larger than 15 mm. A reusable elastic single-port device with 3 working channels was inserted through the 2.5-cm incision at the midpoint between the costal arch and iliac crest on the mid-axillary line. A rigid 10-mm 30° extra-long laparoscope was introduced for monitoring, and a combination of lengthened pre-bent and conventional laparoscopic instruments was used for handling. The surgical procedure was similar to conventional retroperitoneal laparoscopic ureterolithotomy. Results: Retroperitoneal LESS ureterolithotomy was completed in all of the patients. The mean stone size was 18.8 mm (range 16-28). The mean operative time was 108 min (range 75-140). Significant bleeding was not observed, and no major intraoperative complications occurred in any of the patients. The mean hospital stay was 4.4 days (range 3-7). Conclusions: Retroperitoneal LESS ureterolithotomy, using a reusable elastic single-port device, is technically feasible and safe, and the combination of conventional and pre-bent laparoscopic instruments represents an attractive option for retroperitoneal LESS.

scholarly journals Vaginal-assisted gasless laparoendoscopic single-site radical hysterectomy for early cervical cancer: a retrospective pilot study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
Yisong Chen
Keyword(s):  
Cervical Cancer ◽  
Cell Carcinoma ◽  
Radical Hysterectomy ◽  
Single Site ◽  
Perioperative Outcomes ◽  
Oncological Outcomes ◽  
Laparoendoscopic Single Site ◽  
The Mean ◽  
Early Cervical Cancer

Abstract Background Minimally invasive surgery for early cervical cancer is debated. We developed this new vaginal-assisted gasless laparoendoscopic single-site radical hysterectomy for early cervical cancer, and we aimed to evaluate the feasibility and safety of this surgical procedure and observe the early oncologic outcomes. Methods From January 2019 to August 2020, patients with early cervical cancer who underwent vaginal-assisted gasless laparoendoscopic single-site radical hysterectomy were studied retrospectively. The clinical characteristics, pathologic outcomes, perioperative outcomes, and follow-up details of the patients were recorded. Results Forty-eight patients underwent vaginal-assisted gasless laparoendoscopic single-site radical hysterectomy were included, 14 (29.2%) with stage IB1, 13 (27.1%) with stage IB2, 7 (14.6%) with stage IB3, 10 (20.8%) with stage IIA1, and 4 (8.3%) stage with IA2. The mean age at diagnosis was 50.4 (range 28–72) years old. The mean operative time was 237.3 min (range 162–393), and the mean estimated blood loss was 246.5 ml (range 80–800). No intraoperative complications occurred, and there were no patients who were readmitted. Histological types were distributed as follows: squamous cell carcinoma 72.9%, adenocarcinoma 10.4%, and adenosquamous cell carcinoma 16.7%. There were 2 patients (4.2%) with positive nodes, 20 patients (41.7%) with positive lymphovascular space invasion, and 2 patients (4.2%) with positive parametria. Twenty-eight patients (58.3%) received adjuvant therapy after the operation. With a mean follow-up of 17.7 months (range 6–26), there were no recurrent cases, and 11 patients (22.9%) suffered lower limb lymphoedema. Conclusions The vaginal-assisted gasless laparoendoscopic single-site radical hysterectomy might be a feasible technique for early cervical cancer, with promising short-term oncological outcomes and safety. A prospective study with more patients and longer follow-up periods should be performed to further evaluate the safety and oncological outcomes.

Laparoendoscopic single-site (LESS) retroperitoneal adrenalectomy using a homemade single-access platform and standard laparoscopic instruments

2010 ◽  
Vol 25 (4) ◽  
pp. 1251-1256 ◽  
Author(s):  
Shiu-Dong Chung ◽  
Chao-Yuan Huang ◽  
Shuo-Meng Wang ◽  
Huai-Ching Tai ◽  
Yao-Chou Tsai ◽  
...  
Keyword(s):  
Single Site ◽  
Single Access ◽  
Laparoendoscopic Single Site ◽  
Laparoscopic Instruments ◽  
Retroperitoneal Adrenalectomy

A Disease Model to Predict the Long-Term Outcomes Associated with Treatments for Chronic Myelogenous Leukemia (CML).

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4480-4480
Author(s):  
Matthew Taylor ◽  
Lily Lewis ◽  
Thomas Patton ◽  
Ishan Hirji ◽  
Catherine Davis
Keyword(s):  
Disease Model ◽  
Chronic Phase ◽  
Cytogenetic Response ◽  
Utility Value ◽  
Term Survival ◽  
Entire Cohort ◽  
Life Years ◽  
The Mean

Abstract Abstract 4480 Introduction Dasatinib, a BCR-ABL inhibitor 325 fold more potent than imatinib, has been studied in DASISION a randomized comparison vs. imatinib in patients with newly diagnosed chronic phase CML. A computer simulation disease model was developed to examine long-term survival outcomes following treatment with dasatinib, imatinib, or nilotinib in this patient population. Methods A disease model was developed to estimate the lifetime health outcomes associated with each form of treatment. Five initial best-response categories were used (no response (NR), complete hematologic response (CHR), partial cytogenetic response (PCyR), complete cytogenetic response (CCyR) and molecular response (MR)), which were each linked to a disease prognosis based on previously published evidence. Mutually exclusive initial response rates for NR, CHR, PCyR, CCyR and MR came from the DASISION trial for dasatinib and imatinib while those for nilotinib were identified from published ENESTnd data. A quality of life (QoL) utility value was assigned to each health state (chronic phase with response, chronic phase without response, progressed, and dead), also from previous publications. Adverse events were accounted for in terms of their impact upon QoL utility values. Extrapolation beyond the published data was undertaken by calculating trend rates for the final three years of follow up and applying age related mortality rates. Uncertainty was incorporated into the analysis by fitting distributions to survival and using simulation techniques to run 1,000 iterations. The model calculated survival based on the mean number of years’ survival per patient, across the entire cohort. Adjusted QoL utility values were calculated by assigning a QoL utility value weight to each state (see above) and calculating the mean total outcome for the entire cohort. Incremental survival was calculated by comparing the mean survival associated with each treatment. Results The quality adjusted life years (QALYs) and life years (LYs) are given in Table 1. The QALYs and LYs were 12.238 and 14.727 for dasatinib, 11.506 and 13.822 for imatinib and 12.016 and 14.426 for nilotinib, respectively. Conclusion Based on simulation modeling, results suggest that treatment with dasatinib may be associated with long-term survival as well as QoL-adjusted survival benefits. Long-term follow-up of ongoing studies will be needed to confirm these predicted benefits. Disclosures: Taylor: Bristol Myers-Squibb: Consultancy. Lewis:Bristol Myers-Squibb: Consultancy. Patton:Bristol Myers-Squibb: Consultancy. Hirji:Bristol Myers-Squibb: Employment. Davis:Bristol Myers-Squibb: Employment.

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