901 OPERATIVE EXPRIENCE AND SHORT-TERM OUTCOMES OF LAPAROENDOSCOPIC SINGLE-SITE SURGERY (LESS) PYELOPLASTY: A MULTI-INSTITUTIONAL STUDY

Abstract

You have accessJournal of UrologyTechnology & Instruments: Robotics/Laparoscopy/Ureteroscopy II1 Apr 2010901 OPERATIVE EXPRIENCE AND SHORT-TERM OUTCOMES OF LAPAROENDOSCOPIC SINGLE-SITE SURGERY (LESS) PYELOPLASTY: A MULTI-INSTITUTIONAL STUDY Michael Schwartz, Chad Tracy, Soroush Rais-Bahrami, Mohammad Atalla, Sara Best, Sero Andonian, Amin Herati, Louis Kavoussi, Mihir Desai, Jeffrey Cadeddu, and Lee Richstone Michael SchwartzMichael Schwartz New Hyde Park, NY More articles by this author , Chad TracyChad Tracy Iowa City, IA More articles by this author , Soroush Rais-BahramiSoroush Rais-Bahrami New Hyde Park, NY More articles by this author , Mohammad AtallaMohammad Atalla New Hyde Park, NY More articles by this author , Sara BestSara Best Dallas, TX More articles by this author , Sero AndonianSero Andonian New Hyde Park, NY More articles by this author , Amin HeratiAmin Herati New Hyde Park, NY More articles by this author , Louis KavoussiLouis Kavoussi New Hyde Park, NY More articles by this author , Mihir DesaiMihir Desai Cleveland, OH More articles by this author , Jeffrey CadedduJeffrey Cadeddu Dallas, TX More articles by this author , and Lee RichstoneLee Richstone New Hyde Park, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1657AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We report a multi-institutional experience with LESS pyeloplasty to examine operative feasibility, perioperative complications, and short-term outcomes. METHODS Between October, 2007 and April, 2009, peri-operative data from initial experience with LESS pyeloplasty was prospectively collected at 3 institutions. The modified Clavien criteria were used to classify complications. Pre- and post-operative renograms and glomerular filtration rate (GFR) calculation were used to gauge success of the procedure. RESULTS 42 patients underwent LESS pyeloplasty on 44 obstructed ureteropelvic junctions. Mean patient age was 36.7 years (range 10-79) and mean follow-up was 13.9 months (range 1-23 months). Mean operative time was 210±51 minutes. Mean total incision length was 26.8 mm. In 7 right-sided cases, an additional 3 mm port for liver retraction was required. Mean hospital stay was 2.5 days. Pre- and post-operative renal function, as assessed by both renogram and calculated GFR, were not statistically different. Major complications included one post-operative obstruction, and two post-operative urine leaks requiring percutaneous nephrostomy placement. The major complication rate (grades 3-5) was 9.3%. Five patients had not yet undergone post-operative renogram, but all other patients have demonstrated no clinical or radiographic evidence of ureteral obstruction. CONCLUSIONS Given the short-term follow-up data available, LESS is a safe minimally invasive approach to pyeloplasty with success and complication rates similar to those published using robotic or traditional laparoscopic techniques. A minimal scar/incision burden may be particularly advantageous in what is typically a younger patient cohort more concerned with cosmesis. Long-term follow-up data is required to further gauge the durability of these outcomes. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e352 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Schwartz New Hyde Park, NY More articles by this author Chad Tracy Iowa City, IA More articles by this author Soroush Rais-Bahrami New Hyde Park, NY More articles by this author Mohammad Atalla New Hyde Park, NY More articles by this author Sara Best Dallas, TX More articles by this author Sero Andonian New Hyde Park, NY More articles by this author Amin Herati New Hyde Park, NY More articles by this author Louis Kavoussi Ne