Application of 3D-LESS technique in urological operations
WANG Zhi-xiang,LIU Bing,WANG Yang,WU Deng-shuang,SHI Jia-zhi,WANG Lin-hui
(Dept.of Urology, Changzheng Hospital, PLA Second Military Medical University, Shanghai 200003, China;Dept.of Urology,;Dept.of Urology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
Abstract:
Objective To assess the safety and feasibility of 3D laparoendoscopic single-site (3D-LESS) technique in urological operations. Methods Twenty patients received 3D-LESS urological operations in Changhai Hospital from August 2013 to November 2014, including 9 males and 11 females with an average age of 52.8years (31-69 years) and a BMI of 24.64kg/m2. Among 20 operations, 14 were completed via intraperitoneal approach and 6 via retroperitoneal approach; and there were 9 cases of adrenalectomy, 5 of radical nephrectomy, 4 of nephrectomy, 1 of partial nephrectomy and 1 of resection of retroperitoneal cyst. The perioperative parameters, operation time, blood loss, complications and transform to open surgery were analyzed. Results All twenty 3D-LESS operations were smoothly completed and no one was transformed to open surgery. In this study, there were 5 kinds of operations performed with 3D-LESS technique and 3 kinds (adrenalectomy, radical nephrectomy and nephrectomy) of operations performed via both intraperitoneal and retroperitoneal approach. During all the 20 operations, there were no surgical complications. The total operative time was 156.3±56.1min,the hospital stay after operation was 4.5±1.6 days. Donor Visual Analog Pain Scores at postoperative day 3 were 2/10 (2 cases), 1/10 (3 cases) and 0/10(15 cases), respectively. Conclusion Our initial experience shows that the 3D-LESS operation is safe, feasible and effective. The 3D imaging system provides anatomical layering similar to open surgery, and the 3D video techniques would make the LESS operation easier. However, more clinical experiences are needed to be accumulated in the future.
