LaparoEndoscopic Single Site surgery (LESS)

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A new type of surgery done in madras medical mission:
Kindly read the full article published in Times of India:

http://articles.timesofindia.indiatimes.com/2013-10-10/chennai/42899276_1_right-kidney-belly-button-45-year-old-patient

Chennai doctors remove cancerous kidney through belly button

CHENNAI: A team of doctors from the urology department at the Madras Medical Mission (MMM) has removed a cancerous kidney of a patient through the belly button.
Since the patient was anaemic, doctors had to come up with a way to minimise blood loss. The solution was a laparoendoscopic single site surgery (LESS), which is minimally invasive. While the usual surgical procedure leaves a big scar and takes longer time to heal, LESS decreases pain, blood loss and shortens the recovery period without a scar.
The 45-year-old patient from Kerala approached doctors at MMM two weeks ago with signs of renal failure. The patient was put on dialysis and just when he was being prepped for a renal transplant, doctors detected a cancerous mass in his right kidney.
Dr Abraham Kurien, chief of urology, said, "Normally we do a laparoscopic surgery which involves multiple incisions. But since the patient was anaemic we decided to do a minimally invasive procedure. LESS was performed a week ago."
The doctors used the regular equipment used to perform a laparoscopy, but instead of making multiple entries, they inserted all the equipment through his belly button. "We used the grasper and held on to the kidney and disconnected it from the other organs. Then we used a clipper to clip the blood vessels and placed the kidney in a specimen retrieval bag and pulled it out through his naval," said the doctor. The kidney measuring 5cm and the mass was taken out as a whole and not broken as the tissue was cancerous and it had to be sent for pathological tests.
Conventionally doctors do open surgeries which leave bigger incisions through which they used their hands to pull the kidney out. Advancement in technology has made it less invasive, making the patient's stay in the hospital shorter. "This procedure has great cosmetic value as it leaves no scar and the patient can leave in two days. Since the same equipment is used as in a regular laparoscopy surgery, the cost of the procedure is the same but the benefits are much higher," said Dr Kurien.
The doctor pointed out that a laparoscopic procedure provides magnified vision so the accuracy level is much higher and there is minimized muscle damage. Additionally, the technique also has no limitations in bending, kneeling or stooping after recovery, compared to the multi-incision method.
WHAT IS LESS
Laparoendoscopic single site surgery-It is minimally invasive surgical procedure in which the surgeon operates through a single entry point, typically the patient's belly button. The surgical team disconnected the kidney measuring 5 cm from the other organs and clipped the blood vessels. Later the kidney was placed into a specimen retrieval bag and pullet out through the belly button.
WHAT IT REPLACES
Conventional open surgery-Painful, bigger incision, tissue damage, requires removal of a rib, longer hospital stay, heavy blood loss.
PROCEDURE
Minimally invasive, less blood loss, less morbidity, shorter hospital stay, faster recovery
Scar - As the incision is made in the belly button, the scar is not visible.
Duration of surgery - 90 minutes
Blood loss - Cuts 80% of blood loss compared to a conventional surgery
Duration of hospital stay - 48 hours
Cost - Rs. 65,000 (Same as a regular laproscopic surgery)
Who does it - Any trained laproscopic surgeon
Who can get it done - Patients who are not obese

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