Abstract:

Since its initial clinical use in urology, there has been an increasing enthusiasm and a growing interest for laparoendoscopic single-site surgery (LESS). Several clinical series have been reported with an estimated cumulative clinical experience of more than four hundred so far. Nowadays, virtually all extirpative and reconstructive urological procedures have been described and shown to be feasible and safe, including advanced reconstructive procedures and major extirpative ones. Among them, adrenalectomy and partial nephrectomy represent highly complex procedures. Initial clinical data have been recently reported to test the safety and efficacy of these interventions in selected patients. Herein, we describe our initial cases of unclamp LESS partial nephrectomy and adrenalectomy. In our opinion, LESS is an established technique within the field of minimally invasive surgery. Even if further studies are needed to demonstrate its actual benefits, early clinical outcomes are encouraging and LESS might represent the way to go in minimally invasive urological surgery.

Authors:

Luca Cindolo, MD, FEBU, Cesare Scoffone, MD, Luigi Salzano, MD, Riccardo Autorino, MD, PhD, FEBU, Vincenzo Mirone, MD, PhD, Luigi Schips, MD

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Abstract:

We evaluated the safety, efficacy, and potential benefits of using the linear-cutter staplers in the ileal reanastomosis and ileal pouch reconstruction following radical cystectomy in patients with invasive carcinoma of the urinary bladder. Radical cystectomy and orthotopic ileal bladder substitution procedures were performed in 40 patients with invasive carcinoma of the urinary bladder. In 20 patients the linear-cutter stapling device was used for the ileo-ilial reanastomosis and reconstruction of the pouch, while in the other 20 patients the standard hand-suturing technique was used. Using the linear-cutter stapler in the ileo-ileal reanastromasis and ileal pouch reconstruction saved approximately 60 to 90 minutes of operative time, and there was also a significant reduction of blood loss during this period. The leakage rate and hospital stay were less in patients with a stapled pouch. Urodynamic characteristics were comparable to standard ileal neobladders.

Authors:

Ashraf Abou-Elela, PhD, Amr Abou-Elela, PhD, Hany Alfaiomy, PhD, Ahmed Elshafei, PhD.

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