Transumbilical single‐port laparoscopic partial nephrectomy

OBJECTIVE: To present the initial experience with laparoscopic partial nephrectomy (LPN) performed through a transumbilical single port. PATIENTS AND METHODS: Between November 2007 and April 2008, five selected patients underwent single-port LPN (SPLPN) for renal tumours. All procedures were performed through a single intraumbilical multichannel laparoscopic port. A 2-mm grasper was inserted through a 2-mm Veres needle-port in the anterior axillary line to aid in tissue retraction and sutured renal reconstruction. The technique of standard multiport LPN was replicated, with the renal hilum clamped. RESULTS: SPLPN was successfully completed in four patients, while an additional 5-mm port was required in one patient. The median (range) tumour size was 3 (1-5.9) cm. The median (range) operating time was 270 (240-345) min and the estimated blood loss was 150 (100-600) mL. The median (range) warm ischaemia time was 20 (11-29) min. The median (range) length of the umbilical incision was 2.5 (2.5-4) cm. The median (range) hospital stay was 3(3-22) days. There were no intraoperative complications. All surgical margins were negative for tumour. There were no postoperative complications in four patients. One patient had postoperative bleeding and pulmonary embolism. CONCLUSIONS: SPLPN is technically feasible, albeit more challenging than conventional LPN. Proper case selection is essential. Advances in single-port specific instrumentation are needed before these procedures can become a part of mainstream urological laparoscopy.