Chung Shiu-Dong, Huang Chao-Yuan, Wang Shuo-Meng, Chueh Shih-Chieh, Hung Shun-Fa, Tsai Yao-Chou, Yu Hong-Jeng
Far Eastern Memorial Hospital, Taipei, Taiwan, National Taiwan University Hospital, Taipei, Taiwan.
Surg Innov. 2010 Dec;17(4):361-5. doi: 10.1177/1553350610387282. Epub 2010 Nov 22.
To present the initial experience of laparoendoscopic single-site (LESS) nephroureterectomy via the transperitoneal approach using the Alexis wound retractor and bladder cuff resection by endoloop.
Two patients received LESS nephroureterectomies and bladder cuffs resection with homemade single ports, which were created by using an Alexis wound retractor as an access platform through a 4-cm incision. Distal ureters were resected through the same incision with endoloop. No additional ports were used and both procedures were completed successfully.
Both LESS procedures were completed successfully without traditional laparoscopic conversion or complication. LESS nephreoureterectomy with bladder cuff excision was performed in 165 and 325 minutes with estimated blood loss of 30 and 65 mL, respectively. Patients were discharged on postoperative days 3 and 7, respectively.
The initial results demonstrated that LESS technique of nephroureterectomy and bladder cuff resection with endoloop is a safe and feasible procedure for urothelial carcinoma of upper urinary tract.
介绍经腹膜途径使用Alexis伤口牵开器行腹腔镜单孔（LESS）肾输尿管切除术及使用Endoloop进行膀胱袖状切除术的初步经验。
2例患者接受了LESS肾输尿管切除术及膀胱袖状切除术，使用自制单孔，通过将Alexis伤口牵开器作为进入平台，经4cm切口制作而成。远端输尿管通过同一切口使用Endoloop切除。未使用额外的端口，两个手术均成功完成。
两个LESS手术均成功完成，未转为传统腹腔镜手术，也未出现并发症。LESS肾输尿管切除术联合膀胱袖状切除术分别用时165分钟和325分钟，估计失血量分别为30mL和65mL。患者分别于术后第3天和第7天出院。
初步结果表明，LESS技术行肾输尿管切除术及使用Endoloop进行膀胱袖状切除术对于上尿路尿路上皮癌是一种安全可行的手术。
