Technology and EngineeringEmbryonic Natural Orifice Transumbilical Endoscopic Surgery (E-NOTES) for Advanced Reconstruction: Initial Experience
Section snippets
Material and Methods
Laparoscopic single-session bilateral pyeloplasty (2 patients, 4 procedures), laparoscopic ileal ureter interposition (n = 1), and laparoscopic ureteroneocystostomy (n = 1) were performed exclusively through a single umbilical port. No extraumbilical skin incisions were used.
Results
All procedures were technically successful without the need for any extraumbilical skin incisions or additional ports. The perioperative data are outlined in Table 2. The operative time was 4.5 and 6 hours for the bilateral pyeloplasty, 5 hours for the ileal ureteral interposition, and 3 hours for the psoas hitch ureteroneocystostomy. No intraoperative or postoperative complications developed in any patient. The hospital stay was 1 and 2 days for the bilateral pyeloplasty, 3 days for the ileal
Comment
The past decade has witnessed increasing use of laparoscopic techniques for a variety of ablative and reconstructive procedures of the urinary tract.1 With increasing comfort levels in the laparoscopic environment, a wide variety of complex reconstructive procedures requiring skill with intracorporeal suturing and knot tying have been performed with fair regularity at centers of excellence. With the firm establishment of laparoscopic surgery in current urologic practice, ongoing efforts are now
Conclusions
We report the initial experience with advanced laparoscopic reconstruction performed exclusively through a single transumbilical port. All procedures were completed successfully without complications or the need for any extraumbilical incisions. We believe that continuing advances in single-port technology will increase the scope and application of E-NOTES in the near future.
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