Retroperitoneal Laparoendoscopic Single-Site Surgery by Single Trocar Technique: Initial Experience with Renal Cyst Decortication

Objective: To retrospectively review our initial experience with respect to evaluating the feasibility and safety of retroperitoneal laparoendoscopic single- site surgery (LESS) for renal cyst decortication using the single trocar technique. Patients and Methods: Between April 2010 and November 2011, 45 patients with symptomatic simple renal cyst have undergone retroperitoneal LESS using the single trocar technique by the same experienced laparoscopic surgeon. A 10-mm 0 degrees laparoscope with a 6-mm working channel and straight conventional laparoscopic instruments were used during all the procedures. Salient demographic and operative data were recorded, including age, body mass index, operative time, estimated blood loss, perioperative complications, analgesic requirement, etc. Results: Forty-three cases were accomplished successfully. In the remaining 2 patients dense adhesions around the renal cyst were encountered, and the operations were completed with an additional 5-mm trocar. The mean operative time was 49 minutes. The mean estimated blood loss was 12 mL. The mean in-hospital analgesic requirement was 2.8 mg of morphine equivalent. The mean time for ambulation postoperatively was 2 days; at the same time the drainage catheter was removed. The mean hospital stay was 3 days. There were no major perioperative complications, but superficial wound infection was noted in 1 patient. Conclusions: Our initial experience with retroperitoneal LESS by the single trocar technique shows the safety and feasibility for renal cyst decortication and provides acceptable operative outcomes.