Transumbilical laparoendoscopic single-site renal pedicle lymphatic disconnection for refractory chyluria.

PURPOSE: To report our preliminary techniques and experience with transumbilical laparoendoscopic single-site renal pedicle lymphatic disconnection (LESS-RPLD) in seven patients with refractory chyluria.

PATIENTS AND

METHODS

Between June 2009 and September 2010, seven patients with refractory chyluria underwent LESS-RPLD. In the patients, a 2- to 3-cm single inverted U-shaped supraumbilical incision was made, and a homemade single multichannel port using a surgical glove and three conventional trocars was placed into the abdominal cavity. Flexible electric coagulation hook and pliers were used for renal pedicle dissection. A straight ultrasound knife was used for lymphatic disconnection.

RESULTS

All the operations were successfully completed without conversion to open surgery, although an additional 3-mm trocar was used to push the liver in one patient. The mean operative time was 125 (96-165) minutes. The mean blood loss was estimated to be 112 (50-250) mL. Chyluria disappeared in all patients after surgery and did not recur during the follow-up period (3-15, mean 8.3 mos).

CONCLUSION

LESS-RPLD is safe and feasible, with favorable short-term outcomes and aesthetic effect.