Department of Urology, Medical University of Gdansk, Gdansk, Poland.
J Endourol. 2013 Jun;27(6):688-92. doi: 10.1089/end.2012.0674. Epub 2013 May 21.
Various minimally invasive techniques have been developed for bladder diverticulectomy. One of the newest is transvesical laparoendoscopic single-site (T-LESS) surgery. In this article, we present points of technique with initial clinical results after a minimum of 7 months of follow-up. The aim of the study was to assess our first series of patients who underwent T-LESS surgery for transvesical excision of symptomatic bladder diverticula.
From March 2011 to February 2012, we successfully operated on five men aged 61 to 76 years (mean 66 years) for symptomatic (infections, residual of urine, neoplasm) bladder diverticula, with the use of the T-LESS approach. The procedures were performed using single-port TriPort+, standard laparoscopic instruments, and V-loc suture. All patients underwent follow-up of 6 weeks after surgery and every 3 months thereafter. The follow-up included urine tests, ultrasonography, and cystoscopy when needed.
The average operative time was 122 minutes (range 80-175 min), and the blood loss was minimal. Patients were discharged on the third (range 2-4 day) postoperative day with no intra- or postoperative complications. The average 14-month follow-up (range 7-19 mos) confirmed good operative results in all cases. An insignificant small recurrent diverticulum was observed in one patient. The patients did not need transurethral resection of the prostate or reoperation.
We consider this technique to be a feasible and safe procedure, and a valuable treatment option for bladder diverticulectomy.
已经开发出各种微创技术用于膀胱憩室切除术。其中最新的是经膀胱腹腔镜单部位（T-LESS）手术。在本文中，我们介绍了最少 7 个月随访后初始临床结果的技术要点。本研究的目的是评估我们对接受经膀胱 T-LESS 手术切除有症状的膀胱憩室的第一批患者的初步结果。
从 2011 年 3 月至 2012 年 2 月，我们使用 T-LESS 方法成功地对 5 名年龄 61 至 76 岁（平均 66 岁）的男性患者进行了手术，这些患者均患有有症状的（感染、残余尿液、肿瘤）膀胱憩室。手术过程中使用了单端口 TriPort+、标准腹腔镜器械和 V-loc 缝线。所有患者均在术后 6 周进行随访，此后每 3 个月进行一次随访。随访包括尿液检查、超声检查和必要时的膀胱镜检查。
平均手术时间为 122 分钟（范围 80-175 分钟），出血量极少。患者于术后第 3 天（范围 2-4 天）出院，无术中或术后并发症。平均 14 个月的随访（范围 7-19 个月）证实所有病例均取得良好的手术效果。在 1 例患者中观察到一个小的、无意义的复发性憩室。患者无需行经尿道前列腺切除术或再次手术。
我们认为该技术是一种可行且安全的手术，是膀胱憩室切除术的一种有价值的治疗选择。
