Microincision Surgery Successfully Removes Kidney Cancer

A new study confirms that laparoendoscopic single-site surgery (LESS) is safe and feasible for partial and total kidney removal and the excision of life-threatening tumors and blood clots from the main kidney vein.

Researchers at the University of California, Dan Diego (UCSD; USA) conducted prospective pilot evaluation studies of the LESS procedure for radical and cytoreductive nephrectomy, renal vein thrombectomy, and partial nephrectomy. Ten patients (three men, seven women, mean age 58.7 years) underwent the procedures between February and May of 2009. Patient and tumor characteristics, oncologic features, and SF-36 quality of life (QoL) outcome scores were analyzed.

The results, after a median follow-up 9.8 months, showed that 9 out of 10 cases were completed successfully, and all patients had negative margins. The mean operative time was 161 minutes, estimated blood loss was 125 mL, and the incision size was 4.4 cm. The mean preoperative, three-, and six-month postoperative SF-36 QoL Score was 73.8, 74.4, and 77.1, respectively; all patients are currently alive. The study was published ahead of print on June 7, 2010, in the BioMed Central Urology publication Diagnostic and Therapeutic Endoscopy.

"For advanced as well as localized kidney cancer, our surgical team has been able to reduce and consolidate the number of incisions to one port hidden in the belly button,” said lead author Ithaar Derweesh, M.D., an associate professor of surgery at the UCSD Cancer Center. "With one small opening to deploy instruments and remove diseased tissue, patients benefit from fewer complications, minimal opiate-requirements, preserved quality of life, and excellent short term outcomes.”

LESS is an advanced minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient's navel. Since the entire surgery is performed through it, no visible scar is left, as in a traditional multiport laparoscopic approach. Surgeons employing the LESS technique contend that patients benefit from less postoperative pain, less blood loss, faster recovery time, fewer complications, and better cosmetic results.

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University of California, Dan Diego