nephron sparing LESS: technique and review of the current literature

1. nephronsparing LESS: technique and review of the current literature Luca Cindolo, Francesco Greco, Francesco Berardinelli, Fabio Neri, Luigi Schips

2. A B C D E F

3. Unclamptechnique • From 09/2008 to 02/2012 • 21 LESS unclamp NSS • Mean age 59±12y; Mean BMI 25kg/m2 • 110 ± 43min mean operative time • 211 ± 205ml mean blood loss • 50% additional port • (2x 3mm; 5x 5mm) • 2.4±1 cm mean scar size

5. 3 conversions to standard lap (2 bleeding and 1 better exposure) • No major intraoperative complications • No intra and postoperative transfusion • 3/20 postoperative complications • 1 Clavien II • 1 ClavienIIIa • 1 Clavien IV • 2.2/10 Pain Scale Score in POD1 • 4.2±2.2 days mean LOS

6. No significant variation in eGFRand creatinne between baseline and last follow-up • 13 enthusiastic/very satisfied and 7 satisfied • 2.3cm mean tumor size

7. Analysisof the literature • 7 studies; 104 cases LESS NSS • LESS technique duplicate the VLP • Intraoperative and postoperative variables overlapping the standard lap • Prospective studies to define the real benefits and the cost-effectiveness

8. Analysisof the literature