Laparo Endoscopic Single Site Surgery

The department of urology is taking the lead in surgical innovation by pioneering new techniques for urologic surgery that leave little or no visible scar. One new form of surgery performed at Loma Linda University is Laparo-endoscopic Single Site Surgery (also known as LESS)(Figure 1).

In this technique a single small incision is hidden in the folds of a patient’s belly button. Through this single incision even very large kidneys can be removed. The CT scan shown in figure 2 shows a large football sized kidney that was removed in a young patient with recurrent kidney infections and a nonfunctional kidney. Figure 3 shows the single scar that is completely hidden in the patient’s umbilicus. She was discharged home on the day after surgery with minimal pain.

The department of urology is also performing single incision forms of surgery for selected kidney cancers and even to remove kidneys from patients who are donating kidneys to friends or relatives.Figure 4a shows the postoperative outcome and figure 4b shows the kidney removed for donation using a single incision.

Figure 1. LESS surgical device in place at the patient’s belly button.

Figure 2. Large football-sized chronically infected nonfunctional kidney removed using LESS surgery.

Figure 3. Nearly invisible scar seen in a patient after removal of a football sized infected nonfunctional kidney.

Figure 4a. Cosmetic outcome of single incision donor nephrectomy.

Figure 4b. Kidney removed using a single incision.

In addition the department of urology at Loma Linda University is working to develop new and improved ways to advance the boundaries of scarless surgery and to allow these procedures to be performed in a larger number of patients.