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Introduction: Urachal remnants are relatively rare. Generally, urachal remnants are detected in young people, and the removed specimen is small, comprising a good indication for laparoscopic surgery. Laparoendoscopic single-site surgery (LESS) for urachal remnants is considered to be safe and result in an excellent cosmetic outcome. Therefore, we report our single-center experience with LESS for urachal remnants. Methods: We retrospectively reviewed 30 patients with urachal remnants who underwent LESS from January 2011 to December 2017. The patients' characteristics, surgical data, postoperative pain, and cosmetic assessment results were retrospectively collected and analyzed. Results: Mean total operative time was 151 min, mean pneumoperitoneal surgery time was 83 min, and mean estimated blood loss was 5.0 mL. All patients were started on an oral diet and began ambulating on postoperative day 1. Mean hospital stay was 5.5 days. LESS was completed successfully in all patients, with no conversion to conventional or open surgery. Conclusions: LESS is a viable option for the surgical treatment of urachal remnants. This technique may result in less pain than conventional techniques. Further accumulation of surgical outcomes (especially regarding safety and cosmesis) is required for LESS to become an established treatment for urachal remnants. [ABSTRACT FROM AUTHOR]

Objective To report on a multi-institutional series of non-robotic urological laparoendoscopic single-site surgery in Japan. Methods Consecutive cases of laparoendoscopic single-site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates. Results Four hundred and sixty-nine cases were included in the analysis. The most common procedure was adrenalectomy ( n = 177) and the second most common procedure was radical nephrectomy ( n = 143). The procedures also included nephroureterectomy ( n = 40), living donor nephrectomy ( n = 40), pyeloplasty ( n = 30), urachal remnant excision ( n = 9), simple nephrectomy ( n = 7), radical prostatectomy ( n = 6) and others ( n = 17). The access sites included umbilicus ( n = 248, 53%) and other sites ( n = 221, 47%). A transperitoneal approach was used in 385 cases (82%), and retroperitoneal approach in 84 cases (18%). The median operation time of all procedures was 198 min. Conversion to reduced port surgery, conventional laparoscopy, or open surgery was noted in 27 cases (5.8%), 12 cases (2.6%), and two cases (0.4%), respectively, with an overall conversion rate of 8.7%. Intraoperative complications occurred in 10 cases (2.1%). Post-operative complications were noted in 29 cases (6.2%), including five major complications (1.1%). No mortality was recorded in this series. Conclusions Non-robotic laparoendoscopic single-site surgery is technically feasible and safe for various urologic diseases in Japan. Furthermore, urological laparoendoscopic single-site surgery is a promising minimally invasive surgical option that is feasible for experienced urological surgeons in intermediate-volume centers as well as high-volume centers. [ABSTRACT FROM AUTHOR]

Objectives To compare diameter-axial-polar nephrometry score with RENAL nephrometry score for surgical outcomes after laparoscopic partial nephrectomy. Methods We retrospectively reviewed data from 134 patients who underwent laparoscopic partial nephrectomy, using diameter-axial-polar and RENAL scores. We analyzed data for warm ischemic time and estimated blood loss intraoperatively, and percentage change in estimated glomerular filtration rate 6 months and 1 year postoperatively. Both scores were classified as low-, middle- and high-risk, and were used to compare the three analyzed parameters. Results The median tumor size was 2.3 cm (range 1.0-5.4 cm); warm ischemic time was 25.4 min (range 6.5-57 min); and at 6 months and 1 year, percentage change in estimated glomerular filtration rate was 93% (range 51.7-133.3%) and 91% (range 49.4-137.6%), respectively. There were no significant differences in warm ischemic time and estimated blood loss for RENAL between risk groups ( P = 0.38 and 0.09, respectively), but significant differences between groups for diameter-axial-polar score ( P = 0.02 and 0.01, respectively). There were no significant differences in either score between groups for percentage change in estimated glomerular filtration rate at 6 months and 1 year. A total of 27 high-risk cases with a diameter-axial-polar score of seven points underwent laparoscopic partial nephrectomy safely; all three cases with a diameter-axial-polar score of eight points were converted to open partial nephrectomy. Conclusions Diameter-axial-polar score seems to estimate the complexity of tumor characteristics in patients undergoing laparoscopic partial nephrectomy better than RENAL score. It has a better correlation with warm ischemic time and estimated blood loss. [ABSTRACT FROM AUTHOR]