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First 100 cases of transvesical single-port robotic radical prostatectomy

Asian Journal of Urology 2023年第4期10卷 416-422页

作者： Roxana Ramos-Carpinteyro Ethan L.Ferguson Jaya S.Chavali Albert Geskin Jihad Kaouk Glickman Urological&Kidney Institute Cleveland Clinic FoundationClevelandOHUSA

Objective:To describe the surgical technique and report the early outcomes of the transvesical(TV)approach to single-port(SP)robot-assisted radical prostatectomy.Methods:All procedures were performed at a single center by one surgeon.We identified the first 100 consecutive patients with clinically localized prostate cancer that underwent SP TV robot-assisted radical prostatectomy using the da Vinci SP robotic surgical system.Data were collected prospectively and analyzed with descriptive statistics.The primary outcomes assessed were postoperative urinary continence,rate of biochemical recurrence,and sexual function.Results:All procedures were performed without extra ports or conversion.The median age was 62.1 years and 49.0%of the patients had abdominal surgery history.The preoperative median prostate-specific antigen value and prostate volume were 5.0 ng/mL and 33.0 mL,respectively.There were no intraoperative complications.The median operative time and estimated blood loss were 212.5 min and 100.0 mL,respectively.A total of 92.0%of patients were discharged within 24.0 h,with an overall median length of stay of 5.6 h.Only 4.0%of patients required opioid prescriptions at discharge.The median Foley catheter duration was 3 days.Positive margins were present in 15.0%of cases.Median follow-up was 10.4 months.Continence rate was immediate after Foley removal in 49.0%of cases,65.0%at 2 weeks,77.4%at 6 weeks,94.1%at 6 months,and 98.9%at 1 year.One case of biochemical recurrence(1.0%)was noted 3 months after surgery.Conclusion:The SP TV approach for radical prostatectomy cases is a safe and feasible technique for patients with clinically localized prostate cancer.This technique offers advantages of short hospital stay,minimal narcotic use postoperatively,and promising early return of urinary continence,without compromising oncologic outcomes.

关键词： Prostate cancer Radical prostatectomy Robotic-assisted surgery single-port Minimally-invasive surgery

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single-port laparoscopy-assisted vaginal repair of a cesarean scar defect: a single-center retrospective study

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Chinese Medical Journal 2020年第3期133卷 285-291页

作者： Yong-Li Zhang Guo-Cheng Wang Jun-Jie Qu Gui-Qiang Du Wei-Qiang Zhou Department of Obstetrics and Gynecology Shanghai First Maternity and Infant HospitalTongji University School of MedicineShanghai 201204China.

Background:The incidence of uterine cesarean scar defect(niche)is high,and some patients require surgery.single-port laparoscopy can reduce post-operative pain,and provide better cosmetic effects.This study was performed to evaluate the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scar defect(niche)in women after cesarean section.Methods:This study included 74 patients who were diagnosed with uterine cesarean niche at the Shanghai First Maternity and Infant Hospital from January 2013 to June 2015.Thirty-seven patients underwent single-port laparoscopy-assisted vaginal surgery as the case group,and the remaining patients underwent vaginal repair surgery as the control group.We collected data from the inpatient and follow-up medical records.The clinical characteristics of these two groups were compared.The odds ratios and 95%confidential intervals were calculated for each variable by univariate and multivariate analyses.Results:Patients who underwent single-port laparoscopy-assisted vaginal repair had a significantly longer operation time(2.3[2.0-2.7]vs.2.0[1.6-2.3]h,P=0.015),shorter gas passage time(1.2[1.0-1.5]vs.1.7[1.0-2.0]days,P=0.012),shorter hospital stay(3.1[3.0-4.0]vs.4.5[4.0-6.0]days,P=0.019),and fewer complications(0 vs.4 cases).Univariate analysis showed that depth of the niche(P=0.021)the mild adhesiolysis score(P=0.035)and moderate adhesiolysis score(P=0.013)were associated with the bladder injury.Multivariate analysis showed that the moderate adhesiolysis score(P=0.029;95%confidence interval,1.318-3.526)was the strongest independent predictor of bladder injury.Conclusion:This study confirmed the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scars.

关键词： single-port laparoscopy Uterine cesarean scar defect(niche) Adhesion

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A comparison of perioperative outcomes between extraperitoneal robotic single-port and multiport radical prostatectomy with the da Vinci Si Surgical System

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Asian Journal of Andrology 2021年第6期23卷 640-647页

作者： Guan-Qun Ju Zhi-Jun Wang Jia-Zi Shi Zong-Qin Zhang Zhen-Jie Wu Lei Yin Bing Liu Lin-Hui Wang Dong-Liang Xu Department of Urology Changzheng HospitalNaval Medical UniversityShanghai 200003China Urology Centre Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 200021China

To evaluate outcomes between extraperitoneal robotic single-port radical prostatectomy(epR-spRP)and extraperitoneal robotic multiport radical prostatectomy(epR-mpRP)performed with the da Vinci Si Surgical System,comparison was performed between 30 single-port(SP group)and 26 multiport(MP group)cases.Comparisons included operative time,estimated blood loss(EBL),hospital stay,peritoneal violation,pain scores,scar satisfaction,continence,and erectile function.The median operation time and EBL were not different between the two groups.In the SP group,the median operation time of the first 10 patients was obviously longer than that of the latter 20 patients(Psingle-port robotic surgery platform,we can still provide minimally invasive surgery for patients.

关键词： extraperitoneal approach minimally invasive surgery prostate cancer robotic radical prostatectomy single-port

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single-port versus multi-port cholecystectomy for patients with acute cholecystitis: a retrospective comparative analysis

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 521-525页

作者： Dietmar Jacob Roland Raakow Department of Surgery Center for Minimally Invasive Surgery Vivantes Hospital Spandau Neue Bergstrasse 6 13585 Berlin Germany Department of Surgery Vivantes Klinikum Am Urban Dieffenbachstrasse 1 10967 Berlin Germany

BACKGROUND: Trans-umbilical single-port laparoscopic cholecystectomy for chronic gallbladder disease is becoming increasingly accepted worldwide. But so far, no reports exist about the challenging single-port surgery for acute cholecystitis. The objective of this study was to describe our experience with single-port cholecystectomy in comparison to the conventional laparoscopic technique. METHODS: Between August 2008 and March 2010, 73 patients with symptomatic gallbladder disease and histopathological signs of acute cholecystitis underwent laparoscopic cholecystec- tomy at our institution. Thirty-six patients were operated on with the single-port technique (SP group) and the data were compared with a control group of 37 patients who were treated with the multi-port technique (MP group). RESULTS: The mean age in the SP group was 61.5 (range 21-81) years and in the MP group was 60 (range 21-94) (P=0.712). Gender, ASA status and BMI were not significantly different. The number of white blood cells was different before [SP: 9.2 (range 2.8-78.4); MP: 13.2 (range 4.4-28.6); P=0.001] and after the operation [SP: 7.8 (range 3.5-184.8); MP: 11.1 (range 5-20.8); P=0.002]. Mean operating time was 88 (range 34-174) minutes in the SP group vs 94 (range 39-209) minutes in the MP group (P=0.147). Four patients (5%) required conversion to an open procedure (SP: 1; MP: 3; P=0.320). During the follow- up period of 332 (range 29-570) days in the SP group and 428 (range 111-619) days in the MP group (P=0.044), eleven (15%) patients developed postoperative complications (P=0.745) and two patients in the SP group required reoperation (P=0.154). CONCLUSIONS: Trans-umbilical single-port cholecystectomy for beginning acute cholecystitis is feasible and the complicationrate is comparable with the standard multi-port operation. In spite of our good results, these operations are difficult to perform and should only be done in high-volume centers for laparoscopic surgery with experience in single-port surgery.

关键词： laparoscopic surgery single-port cholecystectomy acute cholecystitis

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Thoracoscopy in Cameroon: Indications, Technics and Short Term Results

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Surgical Science 2024年第4期15卷 278-288页

作者： Guy Aristide Bang Richard II Mbele Fabrice Stephane Arroye Betou Arlette Joelle Moukitek Banaken Amos Bella Ela Charles Mve Mvondo Arthur Essomba Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaound&#233 I University Yaound&#233 Cameroon Department of Surgery and Specialities Yaound&#233 Teaching Hospital Yaound&#233 Cameroon General Surgery Service Mvog-Ada District Hospital Yaound&#233 Cameroon Department of Cardiothoracic and Vascular Surgery Laquintinie Hospital Douala Cameroon Department of Cardiothoracic and Vascular Surgery Yaound&#233 General Hospital Yaound&#233 Cameroon Cardiac Center Shisong St. Elizabeth Catholic General Hospital Shisong Kumbo Cameroon

Introduction: Thoracoscopy is a video-assisted surgical approach that mirrors the techniques used in thoracotomy. Our aim is to map the current state of thoracoscopy practice in Cameroon’s hospitals. Methods: This was a descriptive study that collected both retrospective and prospective data over 57 months across four hospitals in Cameroon. It included 13 patients and focused on variables such as socio-demographic factors, clinical profiles, surgical procedures, and postoperative follow-up. Results: Thirteen patients, predominantly male (84.6%, n = 11), with a mean age of 37.5 ± 16 years, were enrolled. Alcohol use (61.5%) and smoking (38.5%) were the most common past histories. The major complaints were dyspnea (84.6%) and chest pain (58.3%). The primary surgical procedure was clot-free thoracoscopy in 30.8% of cases, mainly for persistent hemothorax (41.8%). Most surgeries were elective (76.9%) and performed under general anesthesia with selective intubation (61.5%). The most common approach was single-port thoracoscopy (U-VATS) (76.9%), with no reported difficulties;however, one intraoperative incident occurred and was successfully treated. Drainage was performed systematically in all patients, and one case required conversion to open surgery. Postoperative complications were minor (Clavien-Dindo grade I) and mainly consisted of pain, with a mortality rate of 15.4%. No significant association was found between risk factors and the occurrence of complications or postoperative mortality. Conclusion: Thoracoscopy, a novel approach in our context, primarily focuses on minor thoracic surgeries.

关键词： Thoracoscopy single-port Hemothorax Cameroon

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Technical and instrumental prerequisites for single-port laparoscopic solo surgery:state of art

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World Journal of Gastroenterology 2015年第15期21卷 4440-4446页

作者： Say-June Kim Sang Chul Lee Department of Surgery Daejeon St. Mary’s Hospital College of Medicine The Catholic University of Korea Daejeon

With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery(SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed singleport solo surgery(SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanicaldevices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator's eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.

关键词： Camera holder Laparoscopy single-portlaparoscopic surgery single-port solo surgery Solosurgery

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single-port laparoscopic surgery for sigmoid volvulus

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World Journal of Gastroenterology 2015年第8期21卷 2381-2386页

作者： Byung Jo Choi Won Jun Jeong Say-June Kim Sang Chul Lee Department of Surgery Daejeon St. Mary’s Hospital College of Medicine The Catholic University of Korea

AIM:To report our experience with single-port laparoscopic surgery(SPLS)for sigmoid volvulus(SV).METHODS:Between October 2009 and April 2013,10patients underwent SPLS for SV.SPLS was performed transumbilically or through a predetermined stoma site.Conventional straight and rigid-type laparoscopic instruments were used.After intracorporeal,segmental resection of the affected sigmoid colon,the specimen was extracted through the single-incision site.Patientdemographics and perioperative data were analyzed.RESULTS:SPLS for SV was successful in all 10 patients(4,resection and primary anastomosis;6,Hartmann’s procedure).The median operative time and postoperative hospitalization period were 168(range,85-315)min and 6.5(range,4-29)d,respectively.No intraoperative complications were noted;there were 2 postoperative complications,including 1 anastomotic leak.CONCLUSION:SPLS was a safe and feasible therapeutic approach for SV,when performed by a surgeon experienced in conventional laparoscopic surgery.

关键词： Sigmoid volvulus Laparoscopy single-port Anastomos

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single-port Bilateral Thoracscopic Dorsal Sympathectmy for Primary Hyperhidrosis:Long-Term Outcome

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World Journal of Cardiovascular Surgery 2014年第4期4卷 56-68页

作者： Aram Baram Salam Al Bermani Department of Thoracic and Cardiovascular Surgery Faculty of Medical SciencesSchool of MedicineUniversity of SulaimaniFrancois Mitterrand StreetSulaymaniyah46001Iraq Departement of Thoracic Surgery Sulaimani Directorate of HealthTeaching HospitalFrancois Mitterrand StreetSulaymaniyah46001Iraq

Background: Primary hyperhidrosis of the upper limbs is characterized by over activity of the eccrine sweat glands, primarily occurring on palmar, plantar and axillary regions. It is distressing and often socially disabling condition. Conservative treatment is usually not effective in controlling the disease mainly due to adverse effect of therapies. Endoscopic thoracic sympathectomy is considered as the treatment of choice, causing minimal morbidity and high success rates and patient satisfaction. Objective: The study aims to evaluate the long-term outcomes of single port bilateralthoracoscopic dorsal sympathectomyin treatment of primary hyperhidrosis of the palm and axilla. Methods: In this prospective study, performed primarily by a single surgeon, between August 1st 2010, and August 1st 2012, we performed 200 thoracoscopies on 100 patients with signs and symptoms of primary palmar and axillary hyperhidrosis in different age groups and in both genders, and all were studied and analyzed following treatment by single-port bilateral thoracoscopic dorsal sympathectomy in Sulaimani teaching hospital. Results: Total of 99 patients were satisfied with the outcome of post-surgery with a follow-up in the mean of 27 months and only one patient was reported no change in symptoms postoperatively. Complications reported in 6 patients inform of compensatory sweating (n = 2), Gestatory sweating (n = 1), Pneumothorax (n = 1), Intraoperative minor bleeding (n = 1) and only 1% failure rate was reported. No mortality was reported. Conclusions: single port bilateral thoracoscopic thoracic sympathectomy is a very effective method in the management of primary hyperhidrosis. single port provides less postoperative pain, safety, short operative time, and quick method for the treatment of primary hyperhidrosis in comparison to two or three ports approaches.

关键词： Primary Hyperhidrosis single-port Sympathectomy Long-Term Outcome

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single port laparoscopic hysterectomy: Feasibility and safety

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Open Journal of Obstetrics and Gynecology 2013年第7期3卷 1-3页

作者： Soon Pyo Lee Sun Hye Yang Chun Hoe Ku Sung Ho Lee Jin Woo Shin Department of Obstetrics and Gynecology Gil Medical Center Gachon University Incheon Korea

Objective: To evaluate the feasibility and safety of single-port laparoscopic hysterectomy comparing with multi-port laparoscopic hysterectomy in treatment of benign uterine diseases. Methods: Data were collected retrospectively by review of the medical records of 252 patients who underwent multi-port or single-port laparoscopic surgery for treatment of benign gynecologic diseases. Laparoscopy assisted vaginal hysterectomy (LAVH) was performed for single-port surgery and LAVH and total laparoscopic hysterectomy (TLH) were performed for multi-port surgery. Demographic variables were collected and analyzed by independent t-test and Pearson Chi-Square test. The primary outcome was analyzed by independent t-test and Fisher’s Exact test. Results: A longer operative time was observed in the multi-port surgery group compared with that of the single-port group (p single-port laparoscopic hysterectomy for treatment of benign uterine diseases is a safe and feasible method.

关键词： Laparoscopic Hysterectomy Benign Uterine Diseases single-port

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Evaluation of the single-port Laparoscopic Right Hemicolectomy Learning Curve

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Surgical Science 2013年第10期4卷 433-437页

作者： Virgilio V. George Michael J. Guzman Joshua A. Waters Andrea L. Jester Don J. Selzer Bruce W. Robb Department of Surgery Indiana University School of Medicine Indianapolis USA

Background: The use of single-port laparoscopy has gained popularity within recent years. Part of the appeal in learning this approach is that it draws heavily from concepts mastered through conventional laparoscopy. Various studies have shown the efficacy and feasibility of the single-port laparoscopic approach, but there are few that examine the learning curve in adopting this new technique. Objective: Our goal was to better define the learning curve in performing a single-port laparoscopic right hemicolectomy. Design: A review of prospectively gathered operative data was performed to analyze the results of single-port laparoscopic right hemicolectomies performed within our institution by experienced laparoscopic surgeons. The first 100 cases were divided into quintiles. Comparisons were made among the cohorts regarding patient demographics, operative time, length of stay, conversions, and complications. Results: There was no difference among quintiles with regard to age, sex, BMI, or ASA class. Operative time, conversions, length of stay, and number of complications did not significantly vary among each group of patients. There was a significant difference in estimated blood loss and length of stay between the fifth cohort and the others due to one patient’s poor outcome. Conclusions: The single-port laparoscopic right hemicolectomy learning curve for surgeons already skilled in laparoscopy is short. There are few differences in various outcome measures among groups at any stage in the learning curve. The skills utilized to perform conventional laparoscopic colorectal surgery readily translate to the single-port approach and result in proficiency from nearly the start.

关键词： single-port Laparoscopy Learning Curve Colectomy

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