The duration of the nephrectomy training curve from a single laparoscopic approach

Introduction: Currently, the treatment standard of patients with renal masses and a nonfunctional kidney are endovideo-surgical operations, among which the least invasive are laparoendoscopic single-site (LESS) operations. Objective: Studying of the LESS nephrectomy (LESS-N) learning curve, its effect on the operations results, and comparative analysis of the LESS -N and conventional laparoscopic nephrectomy (CLN) results. Materials and methods: The work is based on the treatment results of 79 patients. There were 37 patients undergoing LESS- N, and 42 - CLN. Surgical indications were renal masses (89%), and nonfunctional kidney (11%). Patients of both groups were comparable by sex, age, BMI, and concomitant illness. In the LESS-N group all operations were performed by a single surgeon, who had no experience of LESS-N, but had stable results of CLN. In the CLN group, all operations were performed by a single surgeon, who had no experience of performing CLN. Learning curve was passed after achieving a stable low rate of perioperative complications. Results: In LESS -N group learning curve was 21 operations. Comparative analysis of the LESS-N and CLN main perioperative results (operation time, length of hospital stay, volume of intraoperative blood loss) didn’t show any difference between two groups. Conclusion: If a surgeon has stable results of CLN, LESS-N learning curve was not less 21 operations. After passing the learning, LESS -N can be an operation of chose for patients with renal tumor nonfunctional kidney.