Robotic Laparoendoscopic Single-Site Surgery Using GelPort as the Access Platform

Robert J. Stein, Wesley White, Raj K. Goel, Brian H. Irwin, George Pascal Haber, Jihad H. Kaouk

Research output: Contribution to journalArticle

148 Citations (Scopus)

Abstract

Background: Laparoendoscopic single-site surgery (LESS) allows for the performance of major urologic procedures with a single small incision and minimal scarring. The da Vinci Surgical System provides advantages of easy articulation and improved ergonomics; however, an ideal platform for these procedures has not been identified. Objective: To evaluate the GelPort laparoscopic system as an access platform for robotic LESS (R-LESS) procedures. Design, setting, and participants: Since April 2008, 11 R-LESS procedures have been completed successfully in a single institutional referral center. For the last four consecutive cases, the GelPort has been used as an access platform through a 2.5-5-cm umbilical incision. Intervention: R-LESS cases performed with the GelPort included pyeloplasty (n = 2), radical nephrectomy (n = 1), and partial nephrectomy (n = 1). Measurements: Perioperative data were obtained for all patients including demographic data, operative indications, operative records, length of stay, complications, and pathologic analysis. Results and limitations: For both pyeloplasty cases, average operative time (OR time) was 235 min and estimated blood loss (EBL) was 38 cm3. For the patient undergoing radical nephrectomy for a 5.1-cm renal tumor, OR time was 200 min and EBL was 250 cm3. The final patient underwent partial nephrectomy without renal hilar clamping for an 11-cm angiomyolipoma with OR time of 180 min and EBL of 600 cm3. All R-LESS procedures attempted with the GelPort were completed successfully and without complication. Average length of hospital stay was 1.75 d (range: 1-2). The partial nephrectomy patient required transfusion of 1 U of packed red blood cells. Conclusions: Use of the GelPort as an access platform for R-LESS procedures provides adequate spacing and flexibility of port placement and acceptable access to the surgical field for the assistant, especially during procedures that require a specimen extraction incision. Additional platform and instrumentation development will likely simplify R-LESS procedures further as experience grows.

Original languageEnglish (US)
Pages (from-to)132-137
Number of pages6
JournalEuropean Urology
Volume57
Issue number1
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

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Robotics
Nephrectomy
Operative Time
Length of Stay
Kidney
Angiomyolipoma
Umbilicus
Human Engineering
Constriction
Cicatrix
Referral and Consultation
Erythrocytes
Demography

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Robotic Laparoendoscopic Single-Site Surgery Using GelPort as the Access Platform. / Stein, Robert J.; White, Wesley; Goel, Raj K.; Irwin, Brian H.; Haber, George Pascal; Kaouk, Jihad H.

In: European Urology, Vol. 57, No. 1, 01.01.2010, p. 132-137.

Research output: Contribution to journalArticle

Stein, Robert J. ; White, Wesley ; Goel, Raj K. ; Irwin, Brian H. ; Haber, George Pascal ; Kaouk, Jihad H. / Robotic Laparoendoscopic Single-Site Surgery Using GelPort as the Access Platform. In: European Urology. 2010 ; Vol. 57, No. 1. pp. 132-137.
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