San Francisco, CA, May 31, 2010–Laparoendoscopic single site (LESS) surgery is a safe option for a variety of urologic procedures, according to researchers presenting data at the 105th Annual Scientific Meeting of the American Urological Association (AUA). Two studies will be presented to the media during a special media session on LESS, a minimally invasive surgical model where only one, small incision is necessary to perform the surgery. The press conference, to be held Monday, May 31, 2010 at 1 p.m. PDT, will be moderated by Jeffrey Cadeddu, MD, of the University of Texas Southwestern Medical Center.
Two separate studies confirm the safety of LESS for a variety of urologic procedures. In the first study, researchers from Korea studied 31 robot-assisted LESS surgeries performed at a single institution from December 2008 through November 2009. Surgeries included partial nephrectomy, nephroureterectomy, simple nephrectomy, radical nephrectomy and adrenalectomy. The average patient was 56.8 years old with a body mass index (BMI) of 23.9 kg/m2. The mean operative time was 199 minutes. Patients suffered normal or better than normal surgical outcomes regarding blood loss and mean ischemic times. After undergoing a partial nephrectomy, each patient was negative for malignancy. There were no reported port-related complications (wound infection, ventral hernia or skin maceration). Two patients were converted to min-incisional access at the last minute due to delayed bleeding or the inability to identify an endophytic mass.
In the second study, researchers from the Cleveland Clinic reviewed a series of 140 LESS procedures performed at the institution between September 2007 and October 2009, to assess intraoperative and postoperative data. Of the cases performed during this time period, 22 were robotic procedures. Surgeries included cryoablation, partial nephrectomy, metastectomy, renal biopsy, simple nephrectomy, radical nephrectomy, cyst decortication, nephroureterectomy, donor nephrectomy, dismembered pyeloplasty, ileal ureter/ureteroureterostomy, varicocelectomy, radical prostatectomy, radical cystectomy, sacral colpopexy, and ureteral reimplant. The average patient was 54 years with a body mass index of 26.1 kg/m2. The mean operative time was 188.8 minutes. Similarly to the previous study, some patients (seven) required conversion to standard laparascopy. Unlike the previous study, authors from the Cleveland Clinic reported complications based on a standardized Clavien Dindo scale: 1 grade I (rectal injury); 10 grade II (transfusion, 8; urinary tract infection, 1; deep vein thrombosis, 1); 2 Grade IIIb (recto-urethral fistula, 1; angioembolization, 1). Authors will also present data on an additional 27 robotic LESS procedures performed since these data were submitted.
“These studies taken together show that LESS is a safe surgical model for a variety of urologic procedures,” Dr. Cadeddu said. “As with all surgical procedures, outcomes will likely depend on the surgeon’s level of experience and the patient’s comorbidities. More research is necessary to evaluate the index patient for these procedures.”
NOTE TO REPORTERS: Experts are available to discuss these studies outside normal briefing times. To arrange an interview with an expert, please contact the AUA Communications Office at the number above or e-mail Communications@AUAnet.org.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 16,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their patients.
Wendy Isett, AUA