Cleveland Clinic surgeon performed the world's first single-port laparoscopic prostatectomy and single-port laparoscopic urinary cystectomy

Cleveland 11 December 2007Jihad H. Kaouk, M.D, Director of Robotic Urologic Surgery at Cleveland Clinic and a pioneer of a Single-Port Laparoscopic (SPL) methodology in the field of urology, recently performed the world's first radical prostatectomy and radical urinary cystectomy - cystoprostatectomy - entirely through a single incision in the navel. The conventional laparoscopic approach to radical prostatectomy for prostate cancer and cystoprostatectomy for bladder cancer utilizes five or six abdominal wall incisions. The true SPL trans-umbilical approach employed by Dr. Kaouk is a variant of the laparoscopic operation that uses only a single small umbilical incision through which a single specially-designed port is placed. There is no utilization of any other accessory ports inside or outside the umbilicus.

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Dr. Kaouk has successfully performed more than 25 urological reconstructive, ablative and excisional operations with this new approach. These procedures include the first SPL radical prostatectomy, radical urinary cystectomy, trans-abdominal sacral colpopexy for vaginal prolapse, kidney tumour cryoablation and radical nephrectomy. Dr. Kaouk also used the single port technique to perform the first single port retroperitoneal kidney surgery and single port laparoscopic paediatric surgery.

The Uni-X Single Port Laparoscopic System, among other instrumentation, was employed during these operations. So far, no intra-operative or postoperative complications have been observed. There were no conversions to conventional laparoscopic approaches or to traditional open procedures.

The initial experience in SPL by Dr. Kaouk and his colleagues at the Cleveland Clinic will be presented at the upcoming American Urological Association in May 2008. This ground-breaking clinical work in Single-Port Laparoscopy was accepted for publication in October of 2007 in the Urology Journal and is in press for the upcoming issue. This represents the first peer-reviewed article on the first accomplished cases in SPL in urology. It also includes the largest experience in ablative and reconstructive single port surgery where all instruments used were passed through the single port without the use of any 2 mm or 3 mm instruments for retraction or assistance.

"Although more clinical experience and scientific studies are required in order to define the patient and health care benefits, the SPL has the potential of improving the patient's outcomes and saving health care dollars", stated Dr. Kaouk.

The Cleveland Clinic Glickman Urological Institute is recognized worldwide for excellence in patient care, teaching and research. Every year since 1990, U.S. News & World Report has ranked the Glickman Urological Institute the best in Ohio and one of the top five urology departments in the United States. For the past seven years, the Glickman Urological Institute has been ranked second in the nation by U.S. News & World Report.

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispeciality academic medical centre that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of co-operation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the United States' best hospitals in its annual "America's Best Hospitals" survey.

Approximately 1500 full-time salaried physicians at Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialities and subspecialities. In 2005, there were 2,9 million outpatient visits to Cleveland Clinic. Patients came for treatment from every state and from more than 80 countries. There were nearly 54.000 hospital admissions to Cleveland Clinic in 2005.

The Uni-X System is the first Single-Port Laparoscopic System which consists of a single multi-cannula laparoscopic port and a variety of curved laparoscopic instruments. The system eliminates the need for additional abdominal wall incisions and laparoscopic ports. The Uni-X Single-Port Laparoscopic System, which was invented by Dr. Gregory Piskun, is being manufactured by Pnavel Systems Inc.


Leslie Versweyveld

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