Abstract
Laparoendoscopic single-site surgery (LESS) was proposed with the aims to further reduce the limited invasiveness of conventional laparoscopy. Nevertheless, LESS remains a challenging surgical technique requiring great surgical skills, due to the lack of triangulation and reduced instruments movement. These limitations emerged more clearly when using LESS approach for reconstructive procedures such as pyeloplasty, in which proper suturing is mandatory to provide adequate repair of the stenotic upper urinary tract junction (UPJ).
In order to overcome this hurdles, the traditional da Vinci® robotic system was recently adapted to the LESS concept with encouraging results. We describe in details the surgical technique of robotic laparoendoscopic single-site (R-LESS) pyeloplasty employing the novel da Vinci Single-Site® platform. The clinical outcomes of the first series of patients submitted to this pyeloplasty technique were also reported.
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References
Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Merety KS, Darcy MD, Long SR, Roemer FD, Pingleton ED, Thomson PG. Laparoscopic nephrectomy. N Engl J Med. 1991;324:1370–1.
Kaouk JH, Autorino R, Kim JF, et al. Laparoendoscopic single-site surgery in urology: worldwide multi-institutional analysis of 1076 cases. Eur Urol. 2011;60:998–1005.
White MA, Haber GP, Autorino R, Khanna R, Altunrende F, Yang B, Stein RJ, Kaouk JH. Robotic laparoendoscopic single-site surgery. BJU Int. 2010;106:923–7.
Haber GP, White MA, Autorino R, Escobar PF, Kroh MD, Chalikonda S, Khanna R, Forest S, Yang B, Altunrende F, Stein RJ, Kaouk JH. Novel robotic da Vinci instruments for laparoendoscopic single-site surgery. Urology. 2010;76:1279–82.
Kroh M, El-Hayek K, Rosenblatt S. First human surgery with a novel single-port robotic system: cholecystectomy using the da Vinci Single-Site platform. Surg Endosc. 2011;25:3566–73.
Wren SM, Curet MJ. Single-port robotic cholecystectomy results from a first human use clinical study of the new da Vinci single-site surgical platform. Arch Surg. 2011;146:1122–7.
Cestari A, Buffi NM, Lista G, Lughezzani G, Larcher A, Lazzeri M, Sangalli M, Rigatti P, Guazzoni G. Feasibility and preliminary clinical outcomes of robotic laparoendoscopic single-site (R-LESS) pyeloplasty using a new single-port platform. Eur Urol. 2012;62:175–9.
Cestari A, Buffi NM, Lista G, et al. Retroperitoneal and transperitoneal robot-assisted pyeloplasty in adults: techniques and results. Eur Urol. 2010;58:711–8.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.
Seideman CA, Bagrodia A, Gahan J, Cadeddu JA. Robotic-assisted pyeloplasty: recent developments in efficacy, outcomes, and new techniques. Curr Urol Rep. 2013;14:37–40.
Braga LHP, Pace K, DeMaria J, Lorenzo JA. Systematic review and meta-analysis of robotic-assisted versus conventional laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: effect on operative time, length of hospital stay, postoperative complications, and success rate. Eur Urol. 2009;56:848–58.
Desai MM, Rao PP, Aron M, Pascal-Haber G, Desai MR, Mishra S, Kaouk JH, Gill IS. Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int. 2008;101:83–8.
Islam A, Castellvi AO, Tesfay ST, Castellvi AD, Wright AS, Scott DJ. Early surgeon impressions and technical difficulty associated with laparoendoscopic single-site surgery: a Society of American Gastrointestinal and Endoscopic Surgeons learning center study. Surg Endosc. 2011;25:2597–603.
Sodergren M, McGregor C, Farne HA, Cao J, Lv Z, Purkayastha S, Athanasiou T, Darzi A, Paraskeva P. A randomised comparative study evaluating learning curves of novices in a basic single-incision laparoscopic surgery task. J Gastrointest Surg. 2013;17:569–75.
Kommu SS. Ex-vivo training model for laparoendoscopic single-site surgery. J Minim Access Surg. 2011;7:104–8.
Best SL, Donally C, Mir SA, Tracy CR, Raman JD, Cadeddu JA. Complications during the initial experience with laparoendoscopic single-site pyeloplasty. BJU Int. 2011;108:1326–9.
Stein RJ, White WM, Goel RK, Irwin BH, Haber GP, Kaouk JH. Robotic laparoendoscopic single-site surgery using GelPort as the access platform. Eur Urol. 2010;57:132–6.
Olweny EO, Park SK, Tan YK, Gurbuz C, Cadeddu JA, Best SL. Perioperative comparison of robotic assisted laparoendoscopic single-site (LESS) pyeloplasty versus conventional LESS pyeloplasty. Eur Urol. 2012;61:410–4.
Eisenberg D, Vidovszky TJ, Lau J, Guiroy B, Rivas H. Comparison of robotic and laparoendoscopic single-site surgery systems in a suturing and knot tying task. Surg Endosc. 2013;27:3182–6.
Seideman CA, Tan YK, Faddegon S, et al. Robotic-assisted laparoendoscopic single-site pyeloplasty: technique using the da Vinci® Si robotic platform. J Endourol. 2012;19:1–15.
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Cestari, A. et al. (2017). Single-Site Robotic Pyeloplasty Employing the Novel-Dedicated da Vinci Platform. In: Kaouk, J., Stein, R., Haber, GP. (eds) Atlas of Laparoscopic and Robotic Single Site Surgery. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-3575-8_23
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DOI: https://doi.org/10.1007/978-1-4939-3575-8_23
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