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- Title
Laparoscopic single-incision triangulated umbilical surgery (SITUS) pyeloplasty: a description of the first 32 cases.
- Authors
Habicher, Martin; Tokas, Theodoros; Herrmann, Thomas RW; Nagele, Udo; Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group
- Abstract
Introduction and objectives: Transumbilical laparoendoscopic (LESS) procedures reduce access trauma. Laparoendocopic single-incision triangulated umbilical surgery (SITUS) utilizes straight instruments in a triangulated fashion, via three trocars placed through a single umbilical incision.Methods: Thirty-two consecutive patients underwent an SITUS pyeloplasty. Access is performed by incision of the umbilical fold by 3/4 of its circumference, a 5-mm camera port, and consequently, cranial and caudal 3 or 5 mm working trocars are placed at a distance of 3-6 cm, thus allowing triangulation. SITUS laparoscopy utilizes the standard straight instruments with a length of 43 cm.Results: All procedures were successfully performed and no conversion to open, or conventional laparoscopic approach was deemed necessary. Thirty patients underwent a dismembered and two a Fenger pyeloplasty. A crossing vessel was identified in 68.75% of the cases. The median laparoscopic and suturing times were 130 and 30 min, respectively; median blood loss was 50 ml. The median duration of hospitalization was 4 days. The visual analogue scores (VAS) reported were 1 on the first and 0 on the third postoperative day. The indwelling double-J or mono-J stents were removed after a median time of 5 weeks and 4 days, respectively. The overall success rate was 96.8%.Conclusions: The SITUS technique for pyeloplasty is an attractive alternative to conventional laparoscopy and a viable competitor to LESS surgery. It combines the common principles of traditional laparoscopy, such as conventional instrumentation and triangulation, with the benefits of single-port surgery.
- Subjects
LAPAROSCOPIC surgery; SURGICAL complications; POSTOPERATIVE care; SURGICAL stents; ENDOSCOPY
- Publication
World Journal of Urology, 2018, Vol 36, Issue 11, p1883
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-018-2308-5