Modified Mini-laparoscopic Surgery Optimized the Laparoscopic Decortication of Renal Cyst.

PURPOSE: This study was to introduce the modified mini-laparoscopic surgery for renal cyst and investigate itsadvantages on operative time, cosmetic effect and pain reduction by comparison with laparo-endoscopic single sitesurgery (LESS) and conventional laparoscopic surgery.

METHODS AND PATIENTS: Between May 2015 and October 2018, 140 consecutive patients with benign renal cystunderwent laparoscopic decortication of renal cyst. Of which, 48 cases were in mini-laparoscopic surgery group(M group), 56 cases in LESS group and 36 cases in conventional laparoscopic surgery group (C group). The operativetime, blood loss, visual analog scale (VAS) and Scar Cosmesis Assessment and Rating (SCAR) Scale wasrecorded.

RESULTS: The mean operative time in M group (26.08±7.70 min) and C group (28.56 ± 7.99 min). was significantlyless than that in LESS group (47.32 ±10.53 min) (P < 0.01). Mean blood loss did not differ between the 3 groups(P > 0.05). Mean VAS pain scores in M group were significantly lower than that of LESS group and C group onpostoperative day (POD) 1 and 3 (P < 0.01). The SCAR scale of POD 30 in C group (6.25 ± 1.0) was significantlyhigher than that in M group (0.77 ± 0.59) and LESS group (0.98 ± 0.70). The postoperative course was uneventfulwith no morbidity within 1to 6 months of follow-up.

CONCLUSION: Modified mini-laparoscopic decortication of renal cyst have more comprehensive advantages comparingwith LESS and conventional laparoscopic surgery. It is convenient and offered significant cosmetic benefitand reduced incisional pain.