Current Clinical Urology
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1 Current Clinical Urology Eric A. Klein, MD, Series Editor Professor of Surgery Cleveland Clinic Lerner College of Medicine Head Section of Urologic Oncology Glickman Urological and Kidney Institute Cleveland, OH, USA More information about this series at
2 Dr Klein Series Editor Led by Eric Klein of the Cleveland Clinic, Current Clinical Urology presents timely topics from world famous urologists at that institution and many others. Topics include the management of prostate cancer, urinary stone disease, male sexual function, chronic prostatitis, urologic robotic surgery, and bladder cancer. Urologists are enabled to stay current with rapid advances in urology. Current Clinical Urology is the leading reference source for clinical research and practice. From the Editor of this issue Jihad H. Kaouk, MD FACS I am excited to present to you this unique book on an evolving and promising approach in laparoscopy. LESS or single port laparo-endoscopic surgery is an attempt to further minimize minimally invasive surgery. Awaiting significant modifications to current laparoscopic and robotic tools, LESS and robotic LESS remains in evolution. Future purpose built robotic systems my hold the key to adopting this new approach in minimally invasive surgery.
3 Jihad H. Kaouk Editor Robert J. Stein Georges-Pascal Haber Associate Editors Atlas of Laparoscopic and Robotic Single Site Surgery
4 Editor Jihad H. Kaouk, MD, FACS Professor of Surgery Department of Urology Cleveland Clinic Lerner College of Medicine Zagarek Pollock Chair in Robotic Surgery, Center for Robotic and Image guided Surgery Glickman Urologic Institute Cleveland, OH USA Associate Editors Robert J. Stein, MD Associate Professor of Surgery Department of Urology Center for Robotic and Image Guided Surgery Glickman Urological and Kidney Institute Cleveland Clinic Cleveland, OH USA Georges-Pascal Haber, MD, PhD Associate Staff Department of Urology Center for Robotic and Image Guided Surgery Glickman Urological Institute Cleveland Clinic Cleveland, OH USA ISSN Current Clinical Urology ISBN DOI / ISSN (electronic) ISBN (ebook) Library of Congress Control Number: Springer Science+Business Media New York 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher re-mains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Humana Press imprint is published by Springer Nature The registered company is Springer Science+Business Media LLC The registered company address is: 233 Spring Street, New York, NY 10013, U.S.A.
5 Contents Part I Introduction to LESS 1 History and Evolution of LESS... 3 Marios Hadjipavlou, Shahid Aziz Anwer Khan, and Abhay Rane 2 Consent and IRB Requirements... 9 Humberto Laydner, Luis Felipe Brandao, and Jihad H. Kaouk 3 Laboratory and Experimental Foundation for LESS Antonio Cicione, Rocco Damiano, and Estevao Augusto Rodrigues Lima Part II Instruments for LESS 4 LESS: Ports, Optics, and Instruments Sammy E. Elsamra, Soroush Rais-Bahrami, and Lee Richstone 5 Robotic Systems in Laparoendoscopic Single-Site Surgery Riccardo Autorino and Jihad H. Kaouk Part III Laparoscopic LESS Surgery 6 LESS Adrenal Surgery Yinghao Sun, Wang Linhui, Liu Bing, and Wang Zhixiang 7 Laparoscopic Single-Site Radical Nephrectomy Rodrigo Donalisio da Silva, Diedra Gustafson, and Fernando J. Kim 8 LESS Partial Nephrectomy Hak J. Lee and Ithaar H. Derweesh 9 Laparoendoscopic Single-Site Nephroureterectomy Sung Yul Park v
6 vi Contents 10 Laparoendoscopic Single-Site Donor Nephrectomy Matthew J. Maurice, Önder Kara, and Jihad H. Kaouk 11 Transvaginal NOTES Nephrectomy Antonio Alcaraz, Luís Peri, and Mireia Musquera 12 LESS Pyeloplasty Robert D. Brown, Humberto Laydner, Georges- Pascal Haber, and Robert J. Stein 13 LESS Ileal Interposition Robert D. Brown, Oktay Akca, Homayoun Zargar, and Robert J. Stein 14 Robotic-LESS Radical Prostatectomy Ernesto R. Cordeiro Feijoo, Rafael Sanchez-Salas, and Eric Barret 15 LESS Radical Cystectomy Javier C. Angulo, Felipe Cáceres, and Pedro M. Cabrera 16 Laparoendoscopic Single-Site (LESS) Sacral Colpopexy Wesley M. White, Ryan B. Pickens, and Robert F. Elder 17 Transvesical LESS Applications Rene J. Sotelo Noguera, Luciano A. Nuñez Bragayrac, and Marino Cabrera Fierro 18 Mini-Laparoscopic Surgery and Hybrid LESS Francesco Porpiglia and Cristian Fiori 19 LESS in the Pediatric Population Selcuk Sahin and Volkan Tugcu Part IV Robotic LESS Surgery 20 Robotic Laparoendoscopic Single-Site Radical Nephrectomy Dinesh Samarasekera and Jihad H. Kaouk 21 Robotic LESS Partial Nephrectomy Christos Komninos, Tae Young Shin, and Koon Ho Rha 22 Robotic-Assisted Laparoendoscopic Single-Site (RLESS) Pyeloplasty Jeffrey C. Gahan and Jeffrey A. Cadeddu
7 Contents vii 23 Single-Site Robotic Pyeloplasty Employing the Novel-Dedicated da Vinci Platform Andrea Cestari, Matteo Ferrari, Matteo Zanoni, Mattia Sangalli, Massimo Ghezzi, Fabio Fabbri, Francesco Sozzi, and Patrizio Rigatti 24 Robotic Laparoendoscopic Single-Site Radical Prostatectomy Michael A. White and Jihad H. Kaouk Part V Outcomes and Future Directions 25 Complications of Laparoendoscopic Single-Site Surgery in Urology Idir Ouzaid, Vishnuvardhan Ganesan, and Georges-Pascal Haber 26 Future Directions of LESS Mark W. Ball and Mohamad E. Allaf Index
8 Contributors Editors Jihad H. Kaouk, MD, FACS Professor of Surgery, Department of Urology, Cleveland Clinic Lerner College of Medicine, Zagarek Pollock Chair in Robotic Surgery, Center for Robotic and Image guided Surgery, Glickman Urologic Institute, Cleveland, OH, USA Associate Editors Robert J. Stein, MD Associate Professor of Surgery, Department of Urology, Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA Georges-Pascal Haber, MD, PhD Associate Staff, Department of Urology, Center for Robotic and Image Guided Surgery, Glickman Urological Institute, Cleveland Clinic, Cleveland, OH, USA Authors Oktay Akca, MD Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA Antonio Alcaraz, MD, PhD Department of Urology, Hospital Clinic, Barcelona, Spain Mohamad E. Allaf, MD James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Javier C. Angulo, MD, PhD Jefe de Servicio de Urología, Department of Urology, Hospital Universitario de Getafe, Profesor Titular de Urología, Universidad Europea de Madrid, Laureate Universities, Madrid, Spain Riccardo Autorino, MD, PhD, FEBU Department of Urology, University Hospitals Urology Institute, Richmond Heights, Cleveland, OH, USA ix
9 x Contributors Mark W. Ball, MD James Buchanan Brady Urological Institute and Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Eric Barret, MD Department of Urology, Institut Montsouris Université Paris-Descartes, Paris, France Liu Bing, MD The Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China Luis Felipe Brandao, MD Department of Urology, Paulista Medicine School from the Federal University of São Paulo, São Paulo, Brazil Robert D. Brown, MD Department of Urology, Cleveland Clinic, Cleveland, OH, USA Pedro M. Cabrera, MD Department of Urology, Hospital Universitario de Getafe, Madrid, Spain Marino Cabrera Fierro, MD Robotics and Minimal Invasive Surgery, Urology Department, Instituto Medico La Floresta, Caracas, Venezuela Felipe Cáceres, MD Department of Urology, Hospital Universitario de Getafe, Madrid, Spain Jeffrey A. Cadeddu, MD Department of Urology, J8.106, UT Southwestern Medical Center, Dallas, TX, USA Urology and Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA Andrea Cestari, MD Urology Department, Scientific Institute Istituto Antonio Cicione, MD Clinical and Experimental Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy Ernesto R. Cordeiro Feijoo, MD, FEBU Department of Urology, Institut Montsouris Université Paris-Descartes, Paris, France Rocco Damiano, MD, PhD Clinical and Experimental Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy Rodrigo Donalisio da Silva, MD Department of Urology, Denver Health Hospital and Authority, Denver, CO, USA Ithaar H. Derweesh, MD Urology, UCSD Medical Center, San Diego, CA, USA Robert F. Elder, MD Women s and Children s Health, Obstetrics and Gynecology Surgery, University of Tennessee Medical Center, Knoxville, TN, USA Sammy E. Elsamra, MD Department of Surgery, Division of Urology, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, USA
10 Contributors xi Fabio Fabbri, MD Urology Department, Scientific Institute Istituto Matteo Ferrari, MD Urology Department, Scientific Institute Istituto Cristian Fiori, MD Division of Urology, Department of Oncology, School of Medicine-University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy Jeffrey C. Gahan, MD Department of Urology, UT Southwestern Medical Center, VA North Texas Health System, Dallas, TX, USA Vishnuvardhan Ganesan Department of Urology, Center for Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA Massimo Ghezzi, MD Urology Department, Scientific Institute Istituto Diedra Gustafson, BS Department of Urology, Denver Health Hospital and Authority, Denver, CO, USA Marios Hadjipavlou, BSc, MBBS, MRCS Department of Urology, Darent Valley Hospital, Dartford, Kent, UK Önder Kara, MD Department of Urology, Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA Shahid Aziz Anwer Khan, FRCS (Urol), FEBU Department of Urology, East Surrey Hospital, Redhill, UK Fernando J. Kim, MD, MBA/MHA, FACS Surgery/Urology, Denver Health Medical Center, Denver, CO, USA Minimally Invasive Urological Oncology, University of Colorado Denver, Denver, CO, USA Christos Komninos, MD, MSc, PhD Urology Department, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea, Korea Humberto Laydner, MD Department of Urology, University Hospitals Urology Institute, Richmond Heights, Cleveland, OH, USA Hak J. Lee, MD Robotics/Minimally Invasive Surgery and Urologic Oncology, Gordon Urology, Gordon Hospital, Calhoun, GA, USA Wang Linhui, MD, PhD The Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China Matthew J. Maurice, MD Department of Urology, Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
11 xii Contributors Mireia Musquera, MD, PhD Department of Urology, Hospital Clinic, Barcelona, Spain Luciano A. Nuñez Bragayrac, MD Robotics and Minimal Invasive Surgery, Urology Department, Instituto Medico La Floresta, Caracas, Venezuela Idir Ouzaid, MD Department of Urology, Center for Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA Sung Yul Park, MD Department of Urology, Hanyang University College of Medicine, Seongdong-gu, Seoul, South Korea Luís Peri, MD Department of Urology, Hospital Clinic, Barcelona, Spain Ryan B. Pickens, MD Division of Urology, Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA Francesco Porpiglia, MD Department of Oncology, Division of Urology, School of Medicine-University of Turin, San Luigi Hospital, Turin, Italy Soroush Rais-Bahrami, MD Urology and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA Abhay Rane, MS, OBE, FRCS (Urol) Department of Urology, East Surrey Hospital, Redhill, UK Koon Ho Rha, MD, PhD Urology Department, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea Lee Richstone, MD Urology Department, The Hofstra North Shore LIJ School of Medicine, Lake Success, NY, USA Patrizio Rigatti, MD Urology Department, Scientific Institute Istituto Estevao Augusto Rodrigues Lima, MD, PhD Urology Department, Hospital de Braga, Braga, Portugal Selcuk Sahin, MD Urology Department, Bakırkoy Research and Training Hospital, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey Dinesh Samarasekera, BSc, MD, FRCSC Urology, Surrey Memorial Hospital, Surrey, BC, Canada Rafael Sanchez-Salas, MD Department of Urology, Institut Montsouris Université Paris-Descartes, Paris, France Mattia Sangalli, MD Urology Department, Scientific Institute Istituto
12 Contributors xiii Tae Young Shin, MD Department of Urology, ChunCheon Sacred Heart Hospital, Hallym University, Chuncheon, Kangwon, South Korea Rene J. Sotelo Noguera, MD Robotics and Minimal Invasive Surgery, Urology Department, Instituto Medico La Floresta, Caracas, Venezuela Francesco Sozzi, MD Urology Department, Scientific Institute Istituto Yinghao Sun, MD, PhD The Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China Volkan Tugcu, MD Urology Department, Bakırkoy Research and Training Hospital, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey Michael A. White, DO, FACOS Department of Urology, Urology San Antonio, San Antonio, TX, USA Wesley M. White, MD Department of Urology, Laparoscopic and Robotic Urologic Surgery, The University of Tennessee Medical Center, Knoxville, TN, USA Matteo Zanoni, MD Urology Department, Scientific Institute Istituto Homayoun Zargar, MBChB, FRACS Department of Urology, Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA Wang Zhixiang The Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China
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