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Transumbilical laparoendoscopic single-site surgery(LESS) partial nephrectomy:a median follow-up of 2 years

Journal of Medical Colleges of PLA(China) 2011年第6期26卷 305-315页

作者： Wang Linhui Wu Zhenjie Liu Bing Yang Qing Xiao Liang Sun Yinghao Department of Urology Changhai Hospital Second Military Medical University Shanghai 200433 China

Objective:Nephron-sparing surgery(NSS) for small renal masses offers a similar functional and oncological outcome to that of radical *** single-site surgery(LESS) emerges as an advanced alternative for reduced invasiveness and improves cosmesis;LESS is developing quickly and its indications have been expanded,but still in its *** aim of this paper is to report our preliminary experience in transumbilical LESS partial nephrectomy(LESS-PN),so as to assess its utility, safety and ***:From August 2009 to October 2010,3 patients underwent transumbilical LESS-PN via a novel multi-channel TriPort by a single experienced urologist in our *** demographics,perioperative and follow-up data were prospectively collected and ***:All the three procedures were successfully completed.A 5-mm ancillary trocar was utilized in all 3 *** mean operative duration was 226.3(210-254 min) with an estimated blood loss of 56.7 ml (20-100 ml).Mean warm ischemia time was 35.7 min(19-48 min).One patient was transfused due to postoperative bleeding. The recovery was uneventful and mean length of postoperative stay was 13 days(12-14 days).At the latest follow-up,all patients remained symptom-free and had normal renal function without evidence of recurrence,and they were delighted for a hidden transumbilical ***:Transumbilical LESS-PN is a feasible and safe procedure albeit extremely technically *** outcomes at a median follow-up of 2 years are promising,while currently it should be reserved for highly selected patients with favorable tumor anatomy and performed by a very experienced laparoscopic surgeon.

关键词： Partial nephrectomy laparoendoscopic single-site surgery Nephron sparing surgery

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laparoendoscopic single-site distal pancreatectomy in pigs

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World Journal of Gastroenterology 2014年第22期20卷 6878-6883页

作者： Dong Wang Zhen-Ling Ji Xiao-Hua Jiang Jing-Min Wang Yu-Yan Tan Yan Wang Ya-Zhou Wen Department of General surgery Zhongda HospitalInstitute for Minimally Invasive SurgerySoutheast University Medical School Department of Obstetrics and Gynecology Zhongda HospitalSoutheast University Medical School Department of Anesthesiology Zhongda HospitalSoutheast University Medical School

AIM: To explore the technique for laparoendoscopic single-site distal pancreatectomy.

关键词： laparoendoscopic single-site surgery LESS Pancreatectomy Fish hook retraction Curved laparoscopic multifunctional operative device

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Transurethral assistant transumbilical laparoendoscopic single-site radical prostatectomy

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Asian Journal of Andrology 2017年第4期19卷 473-476页

作者： Chen Zhu Jian Su Lin Yuan Yang Zhang Zi-Jie Lu Yun Su Ning-Hong Wang Xiao-Jian Gu Qing-Yi Zhu Department of Urology Affiliated Hospital of Nanjing University of Traditional Chinese Medicine Nanjing China.

The laparoendoscopic single-site （LESS） technique is the latest technical innovation in laparoscopic surgery to undergo exponential development in urology. This study undertaken to illustrate our initial experience LESS radical prostatectomy （RP） and analyze early outcomes. Nineteen patients diagnosed with prostate cancer underwent LESS-RP in our institute. The patients were divided into two groups： conventional LESS and transurethral assistant LESS. Preoperative, perioperative, postoperative, pathologic, and functional outcomes data were assessed. With the help of a transurethral assistant, the mean operation and anastomosis time were decreased markedly. No focal positive margins were encountered. No prostate-specific antigen recurrence was detected 1 month postoperatively. Complete continence recovery （no pad） was observed in 32% of the patients at 1 month after the operation. No intraoperative and postoperative complications were reported, LESS-RP is a feasible and effective surgical procedure for treatment of prostate cancer. Moreover, transurethral assistant LESS could reduce the difficulty of LESS-RP and shorten the operation time.

关键词： laparoendoscopic single-site surgery prostate cancer transurethral assistant

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Initial experience of laparoendoscopic single-site radical prostatectomy with a novel purpose-built robotic system

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Asian Journal of Urology 2023年第4期10卷 467-474页

作者： Zheng Wang Chao Zhang Chengwu Xiao Yang Wang Yu Fang Baohua Zhu Shouyan Tang Xiaofeng Wu Hong Xu Yi Zhou Lingfen Wu Zhenjie Wu Bo Yang Yi He Yi Liu Linhui Wang Department of Urology Changhai HospitalNaval Medical UniversityShanghaiChina Department of Anesthesiology Changhai HospitalNaval Medical UniversityShanghaiChina Department of Urology The Affiliated Hospital of Jiaxing UniversityZhejiangChina

Objective This prospective single-arm clinical trial aimed to evaluated the feasibility and safety of the application of the SHURUI system(Beijing Surgerii Technology Co.,Ltd.,Beijing,China),a novel purpose-built robotic system,in single-port robotic radical *** Sixteen patients diagnosed with prostate cancer were prospectively enrolled in and underwent robotic radical prostatectomy from October 2021 to August 2022 by the SHURUI single-port robotic surgical *** demographic and baseline data,surgical,oncological,and functional outcomes as well as follow-up data were *** The mean operative time was 226.3(standard deviation[SD]52.0)min,and the mean console time was 183.4(SD 48.3)min,with the mean estimated blood loss of 116.3(SD 90.0)*** mean length of postoperative hospital stay was 4.50(SD 0.97)*** patients had postoperative complications(Clavien-Dindo Grade II),and both patients improved after conservative *** patients’postoperative prostate-specific antigen levels decreased to below 0.2 ng/mL 1 month after *** mean prostate-specific antigen level further decreased to a mean of 0.0219(SD 0.0641)ng/mL 6 months after *** days postoperatively,12 out of 16 patients reported using no more than one urinary pad per day,and all patients reported satisfactory urinary control without the need for pads 6 months after *** The SHURUI system is safe and feasible in performing radical prostatectomy via both transperitoneal and extraperitoneal *** control and urinary continence were satisfying for patients enrolled *** next phase involves conducting a large-scale,multicenter randomized controlled trial to thoroughly assess the effectiveness and safety of the new technology in a broader population.

关键词： laparoendoscopic single-site surgery Robotic surgical procedure Prostatectomy Prostatic cancer

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Preliminary experience with transperitoneal laparoendoscopic single-site radical nephrectomy using a home-made single-port device in China

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Chinese Medical Journal 2014年第2期127卷 279-283页

作者： Bi Hai Ma Lulin Hou Xiaofei Zhang Shudong Wang Guoliang Zhao Lei Department of Urology Peking University Third Hospital Beijing 100191 China

Background laparoendoscopic single-site （LESS） surgery represents a technique to further reduce morbidity and scarring associated with *** present our preliminary experience with transperitoneal LESS radical nephrectomy （RN） using a home-made single-port device in *** From July 2010 to November 2011,eleven patients with renal tumor not greater than T2 underwent LESS-RN by an experienced laparoscopic surgeon.A home-made single-port device was used through a 5-cm umbilical incision.A combination of standard and articulating laparoscopic instruments was *** sequence of steps of LESS-RN was similar to transperitoneal laparoscopic *** characteristics,perioperative variables and postoperative outcomes were recorded and *** Except for two transperitoneal laparoscopic conversions and one hand-assisted laparoscopic conversion,the other procedures were completed successfully without conversion to open *** mean operative time was 224.5 （155-297） minutes,estimated blood loss was 270.9 （50-900） ml,and hospital stay was 10.4 （5-15） *** mean visual analog pain scale （VAPS） on the first postoperative day was 4.0/*** pathological analysis revealed renal cell carcinoma in all cases with a stage distribution of three T1a,five T1b,and three T2a *** the mean followup period of 21.4 （12-28） months,all patients were alive without evidence of tumor recurrence or metastasis,and were satisfied with the appearance of the *** Transperitoneal LESS-RN using a home-made single-port device is technically feasible and safe in a selected group of patients （low body mass index and stage tumor） and has excellent cosmetic *** preliminary oncologic outcome is not compromised,the long-term evaluation of these patients is awaited.

关键词： renal cell carcinoma laparoendoscopic single-site surgery nephrectomy

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Retroperitoneal laparoendoscopic single-site renal cystectomy(a report of 18 cases)

Retroperitoneal laparoendoscopic single-site renal cystectom...

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2014浙江省医学会男科学泌尿外科学学术年会

作者： ZHU Ru-jian ZHANG Zhong HAN Zi-hua CHEN An-ping Huang LI-fu LIN Yun LI Hai-ping WU Song-jiang WANG Guan-fu WANG Tian-ji Department of Urology Luqiao HospitalTaizhou Enze Medical Center of Zhejiang Province

Objective To describe the technique of retroperitoneal laparoendoscopic single-site renal cystectomy with conventional laparoscopic intruments and evaluate the clinical efficacy,safety and feasibility of the *** Between April 2011 and December 2012,18 cases(8 men and 10 women) of renal cyst underwent retroperitoneal laparoendoscopic single-site renal cystectomy with conventional laparoscopic instruments by single *** mean patient age was 47.6 years(range,35 to 78 years).7 cases on the left side and 11 on the right *** mean longest diameter of renal cyst was 6.5 cm(range,4.2 to 10.5 cm).The patient was placed in the full flank position,and an approximately 3 cm transverse single incision was made 2 to 4 cm above the iliac crest,then a Veress needle was introduced into retroperitoneal space straightly through this skin incision and CO2 was *** primary 10 mm trocar was punctured into the retroperitoneal space through the midst of the incision,then a homemade balloon dilator was placed into the retroperitoneal space through the 10 mm trocar and inflated with 400 to 500 ml of *** two 5 mm trocars were respectively inserted on the each side at the ends of the *** retroperitoneal insufflation with CO2 12 to 15 mmHg,conventional laparoscopic instruments and a 30 degree,10 mm rigid laparoscope were *** procedures were performed according to techniques used in conventional retroperitoneal laparoscopic renal *** All procedures were successfully completed without insertion of the subsidiary port or open *** mean operative time was 47.5 minutes(range,35 to90 minutes).The mean estimated blood loss during the operation was 10.4 ml(range,5 to 20 ml).The postoperative detaining time of drainage tube was 2 to 3 days in 16 *** mean postoperative hospital stay was 4.3 days(range,2 to 7 days).No major perioperative complications were *** mean length of follow-up was 7.8 months(range,

关键词： Laparoscopy laparoendoscopic single-site surgery Retroperitoneal space Renal cyst

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Umbilical laparoendoscopic single-site varicocelectomy:the two-trocar technique

Umbilical laparoendoscopic single-site varicocelectomy:the t...

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2014浙江省医学会男科学泌尿外科学学术年会

作者： ZHU Ru-jian CHEN An-ping ZHANG Zhong HAN Zi-hua Huang LI-fu LIN Yun WANG Guan-fu WANG Tian-ji Department of Urology Luqiao HospitalTaizhou Enze Medical Center of Zhejiang Province

Objective To investigate the safety and feasibility of umbilical laparoendoscopic single-site varicocelectomy using the two-trocar *** Between April 2011 and October 2012,18 consecutive patients underwent umbilical laparoendoscopic single-site varicocelectomy(U-LESV) using the two-trocar technique.16 cases on the left side and 2 cases on both *** approximately 1.0 to 1.5cm arc incision was made in the inferior edge of the umbilicus,then a Veress needle was directed through this skin incision and CO2 was *** the pressure of the pneumoperitoneum reached 15 mm Hg pressure,the primary 5-mm Trocar was punctured on the left side at the ends of the wound,followed by a 5-mm rigid 30 degree cystoscope introduced to allow the placement of the second 5-mm trocar under direct vision on the right side at the ends of the *** conventional laparoscopic grasper and scissors,a parallel incision was made in the posterior peritoneum 2to 3 cm proximal to the internal *** spermatic vessels were then dissected and two or three nonabsorbable polymer Hem-o-lok clips were applied on the spermatic vessels,both veins and *** All procedures were performed successfully and no complications *** mean operative time was 14.5 minutes(range,10 to 25minutes) on the left side and 32.5 minutes(range,30 to 35 minutes) on both *** mean postoperative hospital stay was 3.4 days(range,2 to 5 days).The postoperative follow-up was 3 to 24 months by physical examination and Doppler ultrasonography,and there was no evidence of varicocele recurrence or testicular *** Umbilical laparoendoscopic single-site varicocelectomy using the two-trocar technique is a feasible alternative to varicocele with the advantages of simple procedure,less trauma,quick recovery and improved cosmetic result.

关键词： laparoendoscopic single-site surgery umbilical-LESS laparoscopy varicocelectomy varicocele

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single-incision laparoscopic surgery to treat hepatopancreatobiliary cancer:A technical review

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World Journal of Gastroenterology 2022年第27期28卷 3359-3369页

作者： Shu-Hung Chuang Shih-Chang Chuang Division of General and Digestive surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung 80708Taiwan School of Medicine College of MedicineKaohsiung Medical UniversityKaohsiung 80708Taiwan

single-incision laparoscopic surgery(SILS),or laparoendoscopic single-site surgery,was launched to minimize incisional traumatic effects in the *** SILS,such as cholecystectomies,have been gaining in popularity over the past few *** application in complicated hepatopancreatobiliary(HPB)surgeries,however,has made slow progress due to instrumental and technical limitations,costs,and safety *** minimally invasive abdominal surgery is pushing the boundaries,advanced laparoscopic HPB surgeries have been shown to be comparable to open operations in terms of patient and oncologic safety,including hepatectomies,distal pancreatectomies(DP),and pancreaticoduodenectomies(PD).In contrast,advanced SILS for HPB malignancy has only been reported in a few small case *** of the procedures involved minor liver resections and DP;major hepatectomies were rarely *** laparoscopic PD has not yet been *** herein review the published SILS for HPB cancer in the literature and our three-year experience focusing on the technical aspects.

关键词： Hepatectomy Hepatopancreatobiliary cancer laparoendoscopic single-site surgery Pancreatectomy Pancreaticoduodenectomy single-incision laparoscopic surgery

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Prospective randomized comparison of transumbilical two-port laparoscopic and conventional laparoscopic varicocele ligation

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Asian Journal of Andrology 2017年第1期19卷 34-38页

作者： Guo-Xi Zhang Jan Yang Da-Zhi Long Min Liu Xiao-Feng Zou Yuan-Hu Yuan Ri-Hai Xiao Yi-Jun Xue Xin Zhong Quan-Liang Liu Fo-Lin Liu Bo Jiang Rui-Quan Xu Kun-Lin Xie Department of Urology First Affiliated Hospital of Gannan Medical University Ganzhou 341000 People's Republic of China.

We have established a novel method named transumbilical two-port laparoscopic varicocele ligation （TTLVL） for varicocele, which is still needed to evaluate. In this study, 90 patients with left idiopathic symptomatic varicoceles of grades Ⅱ-Ⅲ according to the Dubin grading system were randomly assigned to TTLVL （n = 45） and conventional laparoscopic varicocele ligation （CLVL）（n = 45）. The demographic, intraoperative, postoperative, and follow-up data were recorded and compared between the two groups. All the procedures in the two groups were completed successfully with no intraoperative complications and no conversions to open surgery. No significant difference was found in the operative time, resuming ambulation, bowel recovery, postoperative hospital stay, and postoperative resolution of scrotal pain between the two groups （P 〉 0.05）. However, the postoperative mean visual analog pain scale scores for TTLVL group were all less at 24 h, 48 h, 72 h, and 7 days postoperatively compared to CLVL （P= 0.001, 0.010, 0.006, and 0.027, respectively）. The mean patient scar assessment questionnaire score in postoperative month 3 was 29.7 for TTLVL group compared with 32.1 for CLVL group （P 〈 0.001）. There was no testicular atrophy observed in both groups during the follow-up period. The study shows that TTLVL is a safe, feasible, and effective minimally invasive surgical alternative to CLVL for the treatment of varicocele. Compared with CLVL, TTLVL may decrease postoperative pain and improve the cosmetic outcomes.

关键词： laparoendoscopic single-site surgery umbilicus varicocelectomy

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single-port transperitoneal robotic-assisted laparoscopic radical prostatectomy (spRALP): Initial experience

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Asian Journal of Urology 2019年第3期6卷 294-297页

作者： Yifan Chang Xiaojun Lu Qingliang Zhu Chuanliang Xu Yinghao Sun Shancheng Ren Department of Urology Changhai HospitalSecond Military UniversityShanghaiChina Department of Urology Jiangdu People’s HospitalYangzhouChina

Objective:To assess the feasibility of single-port transperitoneal robotic-assisted laparoscopic radical prostatectomy(spRALP)and discuss its surgical ***:A 60-year-old male was admitted with an elevated prostate-specific antigen(PSA)level of 13.89 ng/mL and confirmed with prostate cancer on biopsy showing three of 22 positive cores with a Gleason score of 3þ4=*** magnetic resonance(MR)and bone scintigraphy showed organ-confined *** was performed using da Vinci Si HD surgical system,with access of a quadri-channel laparoscopic port placed *** drainage tubes were placed before wound *** surgical procedure was largely in consistence with a conventional robotic-assisted laparoscopic radical ***:The surgery was successfully carried out with a duration of 152 min and an estimated blood loss of 100 *** patient was discharged on postoperative Day 4 after removal of both pelvic drainage *** catheter was removed on postoperative Day *** major complications were *** pathology showed a Gleason score of 3þ4=7 with no extraprostatic extension and negative surgical ***:single-port robotic prostatectomy is feasible using the currently available robotic instruments in most Chinese robotic urological *** preoperative planning and careful patient selection are *** studies concerning perioperative complications and pentafecta outcome compared with the conventional multi-port robotic prostatectomy is required.

关键词： laparoendoscopic single-site surgery Prostate cancer Robotic surgery Surgical technique

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