First Italian Experience in Single-Incision Laparoscopic Nephrectomy

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Surgical Technology International XX - Surgical Overview

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Author(s)

Stefano Gidaro, MD, PhD
Assistant Professor, Department of Surgery
University Chieti-Pescara
Chieti, Italy

Luca Cindolo, MD, FEBU
Consultant Urologist, Urology Unit
S. Pio da Pietrelcina Hospital
Vasto, Italy

Fabiola Raffaella Tamburro, MD
Consultant Urologist, Urology Unit
S. Pio da Pietrelcina Hospital
Vasto, Italy

Nicola Longo, MD, PhD
Consultant Urologist, Department of Urology
University of Naples
Naples, Italy

Vincenzo Mirone,MD
Full Professor, Department of Urology
University of Naples
Naples, Italy

Antonello Forgione, MD, PhD, MBA
Scientific Director, AIMS Academy
Consultant Surgeon, General and Emergency Surgery Department
Niguarda Ca' Granda Hospital
Milan, Italy

Luigi Schips, MD
Associate Professor, Chief Physician, Department of Urology
S. Pio da Pietrelcina Hospital
Vasto, Italy

Abstract

We describe our laparoscopic nephrectomy technique of placing trocars directly on the fascia once the skin and the subcutaneous layers are prepared. A series of 10 consecutive patients were operated on by single-incision laparoscopic nephrectomy (SILN). With a 5-cm mean skin incision, the fascia was prepared and 3/4 trocars inserted separately directly on the fascia. Surgical strategy followed the standard technique, except for the use of articulating instruments and 5-mm optic. Demographics, body mass index (BMI), operative time, blood loss, perioperative complications, transfusions, hemoglobin decrease, analgesic requirement, length of stay, and final pathology were recorded. Postoperative and prior-to-discharge visual analogue scale (VAS) pain evaluations were also collected, together with the limitations inherent in the instruments' placement and parallel
driving during the procedure.