1063 Establishment of Pneumoperitoneum for Renal Surgery Using the Kii Fios First Entry System: Early Experience and Case Series

Introduction The ideal technique for establishing pneumoperitoneum for renal laparoscopic surgery is unknown. Veress and Hasson methods have been commonly employed, but the use of a direct vision entry port is less widely described. The aim of this study was to assess the success, safety, and efficiency of this technique in our first fifty cases. Method The Kii Fios First Entry system was used in all cases. The camera is placed in the trocar and this was advanced under vision, with simultaneous insufflation. Patient BMI, time to pneumoperitoneum, complications, and subsequent hernia rates were recorded. Results Fifty patients were included with mean body mass index 30.5kg/m2. All patients were placed in the lateral position for surgery. The entry port was placed between umbilicus and costal margin. A 10mm port was used for the first 10 cases, with a 5mm port and smaller calibre camera used for the remaining 40. Twenty-two (44%) patients underwent pyeloplasty, 19 (38%) underwent nephrectomy, and 9 (18%) other surgeries. Mean time to establishment of pneumoperitonem was 31 seconds, with the shortest recorded time being 12 seconds. No patient suffered a visceral or vascular injury. The 10mm port sites were closed formally, but 5mm sites were not. No patient has developed a port-site hernia. The First Entry port costs €39 per item. Conclusions The Kii Fios First Entry system represents a safe, easy, and inexpensive alternative for establishing pneumoperitoneum in laparoscopic renal surgery, with very short entry times in this series.