Top

BMC Urology

Published in:

Open Access 01-12-2010 | Case report

Laparo-endoscopic single-site (LESS) radical nephrectomy with renal vein thrombectomy: initial report

Authors: Ryan P Kopp, Jonathan L Silberstein, Ithaar H Derweesh

Published in: BMC Urology | Issue 1/2010

Abstract

Background

By combining trocar sites and extraction incision, Laparo-endoscopic Single-site Surgery (LESS) may provide less morbidity than traditional laparoscopy. Concerns continue about LESS for locally advanced tumors. We present our experience with LESS-radical nephrectomy with renal vein thrombectomy (LESS-RN-RVT)

Case Presentation

Between 5-6/2009, 2 patients underwent LESS-RN-RVT (1 right-/1 left-side). Standard steps of multi-site laparoscopic radical nephrectomy were performed, including stapled renal vein thrombectomy and intact specimen extraction. Both cases were successfully completed by LESS without complications. Mean tumor size was 7.8 cm, incision size 4.5 cm, operative time 152 min, EBL 100 ml, and hospital stay 2.5 days. Both patients had negative margins, and are alive at time of last follow-up. One did not require postoperative opiates.

Conclusions

LESS-RN-RVT is safe and feasible in selected patients with renal vein thrombi. Further accumulation of data and comparison to multiport laparoscopic technique are requisite.

Available only for authorised users

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: 1370-1371.PubMed

Dunn MD, Portis AJ, Shalhav AL, Elbahnasy AM, Heidorn C, McDougall EM, Clayman RV: Laparoscopic versus open radical nephrectomy: a 9-year experience. J Urol. 2000, 164: 1153-1159. 10.1016/S0022-5347(05)67131-5.CrossRefPubMed

Derweesh IH, Goldfarb DA, Abreu SC, Goel M, Flechner SM, Modlin C, Zhou L, Streem SB, Novick AC, Gill IS: Laparoscopic live donor nephrectomy has equivalent early and late renal function outcomes compared with open donor nephrectomy. Urology. 2005, 65: 862-866. 10.1016/j.urology.2004.11.051.CrossRefPubMed

Liao JC, Breda A, Schulam PG: Laparoscopic renal surgery for benign disease. Curr Urol Rep. 2007, 8: 12-18. 10.1007/s11934-007-0016-6.CrossRefPubMed

Burgess NA, Koo BC, Calvert RC, Hindmarsh A, Donaldson PJ, Rhodes M: Randomized trial of laparoscopic v open nephrectomy. J Endourol. 2007, 21: 610-613. 10.1089/end.2006.0277.CrossRefPubMed

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: 83-88. 10.1111/j.1464-410X.2007.07423.x.CrossRefPubMed

Raman JD, Cadeddu JA, Rao P, Rane A: Single-incision laparoscopic surgery: initial urological experience and comparison with natural-orifice transluminal endoscopic surgery. BJU Int. 2008, 101: 1493-1496. 10.1111/j.1464-410X.2008.07586.x.CrossRefPubMed

Ponsky LE, Cherullo EE, Sawyer M, Hartke D: Single access site laparoscopic radical nephrectomy: initial clinical experience. J Endourol. 2008, 22: 663-666. 10.1089/end.2007.0427.CrossRefPubMed

Guzzo TJ, Schaeffer EM, McNeil BK, Pollock RA, Pavlovich CP, Allaf ME: Laparoscopic radical nephrectomy for patients with pathologic T3b renal-cell carcinoma: the Johns Hopkins experience. J Endourol. 2009, 23: 63-67. 10.1089/end.2008.0451.CrossRefPubMed

10.

Henderson A, Murphy D, Jaganathan K, Roberts WW, Wolf JS, Rane A: Hand-assisted laparoscopic nephrectomy for renal cell cancer with renal vein tumor thrombus. Urology. 2008, 72: 268-272. 10.1016/j.urology.2008.02.026.CrossRefPubMed

11.

Martin GL, Castle EP, Martin AD, Desai PJ, Lallas CD, Ferrigni RG, Andrews PE: Outcomes of laparoscopic radical nephrectomy in the setting of vena caval and renal vein thrombus: seven-year experience. J Endourol. 2008, 22: 1681-1685. 10.1089/end.2008.0035.CrossRefPubMed

12.

Ponsky LE, Steinway ML, Lengu IJ, Hartke DM, Vourganti S, Cherullo EE: A Pfannenstiel single-site nephrectomy and nephroureterectomy: a practical application of laparoendoscopic single-site surgery. Urology. 2009, 74: 482-5. 10.1016/j.urology.2009.06.002.CrossRefPubMed

13.

Andonian S, Herati AS, Atalla MA, Rais-Bahrami S, Richstone L, Kavoussi LR: Laparoendoscopic Single-Site Pfannenstiel Donor Nephrectomy. Urology. 2009,

14.

Varkarakis IM, Bhayani SB, Allaf ME, Inagaki T, Gonzalgo ML, Jarrett PW: Laparoscopic-assisted nephrectomy with inferior vena cava tumor thrombectomy: preliminary results. Urology. 2004, 64: 925-929. 10.1016/j.urology.2004.05.044.CrossRefPubMed

15.

Bloom JH, van Poppel H, Marechal JM, Jacqmin D, Schroder FH, de Prjck L, Sylvester R, EORTC Genitourinary Tract Cancer Group: Radical nephrectomy with and without lymph-node dissection: final results of European Organization for Research and Treatment of Cancer (EORTC) randomized phase 3 trial 30881. Eur Urol. 2009, 55: 28-34. 10.1016/j.eururo.2008.09.052.CrossRef

16.

Reiger NA, Lam FF: Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation. Surg Endosc. 2010, 24: 888-90. 10.1007/s00464-009-0683-0.CrossRef

17.

Fader AN, Escobar PF: Laparoendoscopic single-site surgery (LESS) in gynecologic oncology: technique and initial report. Gynecol Oncol. 2009, 114: 157-61. 10.1016/j.ygyno.2009.05.020.CrossRefPubMed

18.

White WM, Haber GP, Goel RK, Cruzet S, Stein RJ, Kaouk JH: Single-port urological surgery: single-center experience with the first 100 cases. Urology. 2009, 74: 801-804. 10.1016/j.urology.2009.04.030.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2490/10/8/prepub

Title: Laparo-endoscopic single-site (LESS) radical nephrectomy with renal vein thrombectomy: initial report
Authors: Ryan P Kopp
Jonathan L Silberstein
Ithaar H Derweesh
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2010
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/1471-2490-10-8

At a glance: The STEP trials

Springer Medicine

Laparo-endoscopic single-site (LESS) radical nephrectomy with renal vein thrombectomy: initial report

Abstract

Background

Case Presentation

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case Presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

Expression and biological-clinical significance of hTR, hTERT and CKS2 in washing fluids of patients with bladder cancer

A systematic review and meta-analysis of bone metabolism in prostate adenocarcinoma

Type 1 plasminogen activator inhibitor (PAI-1) in clear cell renal cell carcinoma (CCRCC) and its impact on angiogenesis, progression and patient survival after radical nephrectomy

Complications of circumcision in male neonates, infants and children: a systematic review

Association between gefitinib and hemorrhagic cystitis and severely contracted bladder: a case report

Leiomyoma of the bladder presenting as acute urinary retention in a female patient: urodynamic analysis of lower urinary tract symptom; a case report