Share
array:22 [ "pii" => "S2173578614001541" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2014.11.003" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "671" "copyright" => "AEU" "copyrightAnyo" => "2014" "documento" => "article" "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2015;39:63-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 307 "formatos" => array:3 [ "EPUB" => 11 "HTML" => 187 "PDF" => 109 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0210480614001673" "issn" => "02104806" "doi" => "10.1016/j.acuro.2014.04.006" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "671" "copyright" => "AEU" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2015;39:63-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 326 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 233 "PDF" => 84 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Destreza e ingenio</span>" "titulo" => "Colecistectomía y nefrectomía radical por puerto único umbilical en un mismo acto quirúrgico" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "63" "paginaFinal" => "65" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Trans-umbilical single-port radical nephrectomy with concomitant cholecystectomy" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 700 "Ancho" => 700 "Tamanyo" => 89874 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">TAC helicoidal: tumoración real derecha de 4,5<span class="elsevierStyleHsp" style=""></span>cm.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.A. Campos Sañudo, F. Ruiz Izquierdo, J.M. Gutierrez Cabezas, J.M. Monge Mirallas, A. Asensio Lahoz, A. Ingelmo Setien" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.A." "apellidos" => "Campos Sañudo" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Ruiz Izquierdo" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Gutierrez Cabezas" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Monge Mirallas" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Asensio Lahoz" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Ingelmo Setien" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173578614001541" "doi" => "10.1016/j.acuroe.2014.11.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578614001541?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480614001673?idApp=UINPBA00004N" "url" => "/02104806/0000003900000001/v2_201706012252/S0210480614001673/v2_201706012252/es/main.assets" ] ] "itemAnterior" => array:18 [ "pii" => "S2173578614001619" "issn" => "21735786" "doi" => "10.1016/j.acuroe.2014.11.010" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "647" "copyright" => "AEU" "documento" => "article" "subdocumento" => "ssu" "cita" => "Actas Urol Esp. 2015;39:57-62" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 231 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 168 "PDF" => 53 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>" "titulo" => "Role of testis-sparing surgery in the conservative management of small testicular masses: Oncological and functional perspectives" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "57" "paginaFinal" => "62" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Papel de la cirugía conservadora testicular en el manejo conservador de masas testiculares pequeñas: perspectivas oncológicas y funcionales" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Borghesi, E. Brunocilla, R. Schiavina, G. Gentile, H. Dababneh, L. Della Mora, C. del Prete, A. Franceschelli, F. Colombo, G. Martorana" "autores" => array:10 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Borghesi" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Brunocilla" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Schiavina" ] 3 => array:2 [ "nombre" => "G." "apellidos" => "Gentile" ] 4 => array:2 [ "nombre" => "H." "apellidos" => "Dababneh" ] 5 => array:2 [ "nombre" => "L. Della" "apellidos" => "Mora" ] 6 => array:2 [ "nombre" => "C." "apellidos" => "del Prete" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Franceschelli" ] 8 => array:2 [ "nombre" => "F." "apellidos" => "Colombo" ] 9 => array:2 [ "nombre" => "G." "apellidos" => "Martorana" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480614000722" "doi" => "10.1016/j.acuro.2014.02.020" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480614000722?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578614001619?idApp=UINPBA00004N" "url" => "/21735786/0000003900000001/v1_201501230116/S2173578614001619/v1_201501230116/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Skill and talent</span>" "titulo" => "Trans-umbilical single-port radical nephrectomy with concomitant cholecystectomy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "63" "paginaFinal" => "65" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.A. Campos Sañudo, F. Ruiz Izquierdo, J.M. Gutierrez Cabezas, J.M. Monge Mirallas, A. Asensio Lahoz, A. Ingelmo Setien" "autores" => array:6 [ 0 => array:4 [ "nombre" => "J.A." "apellidos" => "Campos Sañudo" "email" => array:1 [ 0 => "jose.antonio.campos.s@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Ruiz Izquierdo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.M." "apellidos" => "Gutierrez Cabezas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "J.M." "apellidos" => "Monge Mirallas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Asensio Lahoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "A." "apellidos" => "Ingelmo Setien" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Urología, Hospital Sierrallana, Torrelavega, Cantabria, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía General, Hospital Sierrallana, Torrelavega, Cantabria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Colecistectomía y nefrectomía radical por puerto único umbilical en un mismo acto quirúrgico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 467 "Ancho" => 1301 "Tamanyo" => 84595 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Esthetic result of umbilical scar at 1 and 3 months, respectively.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The application of minimally invasive techniques in urology continues forward looking for lower morbidity and better cosmetic results. Within this field, Laparoendoscopic single site surgery (LESS) or single-port surgery is the one that is currently being developed.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Sometimes it is necessary to perform surgery on the same surgery involving different organs outside the field of urology, which surgical specialties general surgery or gynecology handle.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Presentamos la realización de colecistectomía y nefrectomía radical por puerto único umbilical en un mismo acto quirúrgico que solamente requirió una ligera modificación de la posición del paciente de decúbito supino a decúbito lateral para su realización.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Casuistry</span><p id="par0020" class="elsevierStylePara elsevierViewall">We report the case of a 56-year-old patient in whom, during admission for acute pancreatitis, the presence of a 4.5-cm renal tumor of mesorenal location and the presence of cholelithiasis are observed in helical CT (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Once the pancreatitis symptoms are overcome, cholecystectomy and umbilical single-port radical nephrectomy are decided.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Surgical technique</span><p id="par0030" class="elsevierStylePara elsevierViewall">Under general anesthesia, the patient is placed in supine, 4-cm umbilical incision is made, and the TriPort+<span class="elsevierStyleSup">®</span> system (Olympus) is introduced. As a camera, we used a 5-mm flexible handle video laparoscope, which enables the surgeon and his assistant to position their hands at two different levels. During surgery, a curved clamp was placed on the left hand and a straight clamp on the right, thus, allowing for triangulation. First, we performed cholecystectomy according to the usual laparoscopic technique using 2 clamps, removing the piece with a bag without retractor ring.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Then we made the right radical nephrectomy. To assist in the cranial dislocation of the lower renal pole we used a 2.3-mm Alligator Grasper<span class="elsevierStyleSup">®</span> (Stryker), which will later be used for liver removal when releasing the upper renal pole. We clipped the renal artery and vein with Hem-o-lok<span class="elsevierStyleSup">®</span> (Teleflex Medical). Extraction with bag without retractor ring.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">The operative time was 205<span class="elsevierStyleHsp" style=""></span>min, with approximately 250<span class="elsevierStyleHsp" style=""></span>ml bleeding, the postoperative period had no complications, being discharged after 3 days. The pathological anatomies of the surgical specimens gave us the result of:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><p id="par0045" class="elsevierStylePara elsevierViewall">Right kidney: 4.5-cm clear cell carcinoma that focally infiltrates the perirenal adipose tissue; Fuhrman grade II; respects the surgical margins; pT3a, and 1.5-cm angiomyolipoma.</p></li><li class="elsevierStyleListItem" id="lsti0010"><p id="par0050" class="elsevierStylePara elsevierViewall">Gallbladder: Chronic cholecystitis, cholelithiasis, and cholesterolosis.</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">During the check-up at 3 and 6 months, the patient remained asymptomatic both at the gastrointestinal and urological level (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">In certain cases, it is necessary to perform surgeries that can affect various intraabdominal organs requiring collaboration between urologists, general súrgenos, and gynecologists using a multidisciplinary approach. Performing multiple surgeries using the same incision has been used in open surgery in multiple combinations. With the further development of laparoscopic surgery, which provides the patient with lower postoperative morbidity and better cosmetic result, these combined surgeries began to be performed laparoscopically.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> With the emergence of single-port surgery, most of the surgeries that before we performed by means of classic laparoscopy, now can be performed with a single input port.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The specialty of general surgery already has extensive experience in performing single-port cholecystectomies<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> and gradually LESS surgery in urology is expanding in Spain.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> It possibly influences the degree of extension of this technique in the field of general surgery, which in this case have 2 interventions such as cholecystectomy and appendectomy where the complication rate is low, and this allows them to perform a learning curve faster than the one that we urologists can have. In Spain there are groups that have reported their experience in oncologic surgery,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> as well as in live donor transplant<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> with a high level and showing the possibilities offered by this type of approach. We believe it is necessary to advance in the use of clinical simulation to have effective training models to perform an initial learning curve.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">However, not everything is advantageous in this type of surgery, as there is a loss of triangulation, a frequent crash of instruments and difficulties due to the proximity of the hands, which currently cannot be avoided and which generate an increase in the technical difficulty of this surgery. We would like to advise the use of systems which include a 15-mm port because, this way, we can introduce an extraction bag with retractor ring which greatly facilitates the removal of the piece reducing surgical time.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Nevertheless, we consider that it is a feasible and reproducible technique in urologists with laparoscopic skill and experience, making it possible to apply it in regional hospitals like ours. We hope that in the future there are new technological advances to overcome the difficulties inherent to this surgery, allowing for more rapid expansion.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusion</span><p id="par0080" class="elsevierStylePara elsevierViewall">Single-port umbilical surgery makes it possible to perform surgical approaches of different intraabdominal organs with a simple change of position, providing the advantages of a single, small incision, such as decreased postoperative pain and better cosmetic result.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The application of this technique can be performed in 2nd care level hospitals like ours, single-port surgery being both reproducible and economically affordable.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interest</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:2 [ "identificador" => "xres413790" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objectives" 2 => "Materials and methods" 3 => "Results" 4 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec389455" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres413791" "titulo" => array:5 [ 0 => "Resumen" 1 => "Objetivos" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec389454" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Casuistry" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Surgical technique" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusion" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-04-27" "fechaAceptado" => "2014-04-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec389455" "palabras" => array:4 [ 0 => "Cholecystectomy" 1 => "Nephrectomy" 2 => "Single-port surgery" 3 => "Laparoendoscopic single site surgery" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec389454" "palabras" => array:4 [ 0 => "Colecistectomía" 1 => "Nefrectomía" 2 => "Puerto único" 3 => "<span class="elsevierStyleItalic">Laparoendoscopic single site surgery</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Occasionally, the development of laparoscopic procedures allows the performance of combined surgeries. Currently, some of these can be carried out by trans-umbilical single-port laparoscopy.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We report a patient with renal tumor of 4.5<span class="elsevierStyleHsp" style=""></span>cm and cholelithiasis who undergone to trans-umbilical single port-right radical nephrectomy with concomitant cholecystectomy. This is the first case reported in Spain that this combined procedure is performed using umbilical single port surgery.</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">No complications (intra or postoperative) have been described in this case, achieving proper control of tumor pathology and an excellent cosmetic outcome.</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In those cases in which multidisciplinary approach is required, surgery can be performed by trans-umbilical single-port laparoscopy as consequence of its reduced postoperative morbidity and better cosmetic results.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La evolución de los procedimientos laparoscópicos hace que sea necesario en ocasiones, la realización de cirugías combinadas con otras especialidades. Actualmente, algunas de estas intervenciones se pueden realizar mediante cirugía por puerto único umbilical.</p> <span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un paciente con tumoración renal de 4,5<span class="elsevierStyleHsp" style=""></span>cm y colelitiasis al que realizamos colecistectomía y nefrectomía radical derecha por puerto único umbilical de manera concomitante. Este es el primer caso publicado en España en el que se realiza esta intervención combinada mediante cirugía de puerto único umbilical.</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se realizó la cirugía sin complicaciones intraoperatorias ni postoperatorias, con un correcto control de la patología tumoral y un excelente resultado estético.</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En las situaciones que sean necesarias realizar un abordaje multidisciplinar con otras especialidades quirúrgicas involucradas, estas se pueden realizar mediante cirugía por puerto único umbilical, con las ventajas de una menor morbilidad postoperatoria y un mejor resultado estético.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Campos Sañudo JA, Ruiz Izquierdo F, Gutierrez Cabezas JM, Monge Mirallas JM, Asensio Lahoz A, Ingelmo Setien A. Colecistectomía y nefrectomía radical por puerto único umbilical en un mismo acto quirúrgico. Actas Urol Esp. 2015;39:63–65.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 701 "Ancho" => 701 "Tamanyo" => 91377 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Helical CT: 4.5-cm right actual tumor.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 467 "Ancho" => 1301 "Tamanyo" => 84595 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Esthetic result of umbilical scar at 1 and 3 months, respectively.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Ahmed" 1 => "T.T. Wang" 2 => "V.M. Patel" 3 => "K. Nagpal" 4 => "J. Clark" 5 => "M. Ali" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00464-010-1208-6" "Revista" => array:6 [ "tituloSerie" => "Surg Endosc" "fecha" => "2011" "volumen" => "25" "paginaInicial" => "378" "paginaFinal" => "396" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20623239" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combined cholecystectomy and radical genitourinary cancer surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B.J. DeBrock" 1 => "B.E. Davis" 2 => "M.J. Noble" 3 => "J.W. Weigel" 4 => "M.S. Austenfeld" 5 => "W.K. Mebust" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "1993" "volumen" => "41" "paginaInicial" => "103" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8497978" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Concomitant laparoscopic renal surgery and cholecystectomy: outcomes and technical considerations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Tsivian" 1 => "A. Konstantinovsky" 2 => "M. Tsivian" 3 => "S. Kyzer" 4 => "T. Ezri" 5 => "A. Stein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/end.2009.0054" "Revista" => array:6 [ "tituloSerie" => "J Endourol" "fecha" => "2009" "volumen" => "23" "paginaInicial" => "1839" "paginaFinal" => "1842" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19630482" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laparoendoscopic single-site surgery for treatment of concomitant ovarian cystectomy and cholecystectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Surico" 1 => "S. Gentilli" 2 => "A. Vigone" 3 => "E. Paulli" 4 => "L. Leo" 5 => "N. Surico" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jmig.2010.05.005" "Revista" => array:6 [ "tituloSerie" => "J Minim Invasive Gynecol" "fecha" => "2010" "volumen" => "17" "paginaInicial" => "656" "paginaFinal" => "659" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20728828" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colecistectomía laparoscópica de puerto único en un programa de CMA" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Martín Fernández" 1 => "A. Jara Sánchez" 2 => "M.C. Manzanares Campillo" 3 => "P. Menéndez Sánchez" 4 => "V. Muñoz Atienza" 5 => "D. Padilla Valverde" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ciresp.2010.08.003" "Revista" => array:6 [ "tituloSerie" => "Cir Esp" "fecha" => "2010" "volumen" => "88" "paginaInicial" => "328" "paginaFinal" => "331" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20965500" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio prospectivo aleatorizado comparativo entre colecistectomía laparoscópica versus colecistectomía por puerto único en régimen ambulatorio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Herrero" 1 => "E. Cugat" 2 => "M.I. García" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ciresp.2012.07.009" "Revista" => array:6 [ "tituloSerie" => "Cir Esp" "fecha" => "2012" "volumen" => "90" "paginaInicial" => "641" "paginaFinal" => "646" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23039993" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estado actual de la cirugía transumbilical por puerto único en urología: retos y aplicaciones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.M. García-Mediero" 1 => "P.M. Cabrera" 2 => "F. Cáceres" 3 => "E. Mateo" 4 => "A. García-Tello" 5 => "J.C. Angulo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2012.07.001" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "106" "paginaFinal" => "113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22999345" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cistectomia radical laparoencoscopica con neovejiga ileal ortotópica a través de puerto único umbilical" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.C. Angulo" 1 => "F. Cáceres" 2 => "I. Arance" 3 => "I. Romero" 4 => "F. Ramón de Fata" 5 => "P.M. Cabrera" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2012.03.005" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2012" "volumen" => "36" "paginaInicial" => "554" "paginaFinal" => "561" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22704787" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experiencia pionera en España con nefrectomía LESS de donante vivo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Musquera" 1 => "L. Peri" 2 => "L. Izquierdo" 3 => "P. Campillo" 4 => "M.J. Ribal" 5 => "A. Alcaraz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2011.04.007" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2011" "volumen" => "35" "paginaInicial" => "559" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21696861" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Puesta en marcha de un programa de entrenamiento para laparoscopia urológica por puerto único" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Cáceres" 1 => "P.M. Cabrera" 2 => "E. Mateo" 3 => "G. Andrés" 4 => "F. Lista" 5 => "A. García" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.acuro.2012.03.012" "Revista" => array:6 [ "tituloSerie" => "Actas Urol Esp" "fecha" => "2012" "volumen" => "36" "paginaInicial" => "418" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22704788" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735786/0000003900000001/v1_201501230116/S2173578614001541/v1_201501230116/en/main.assets" "Apartado" => array:4 [ "identificador" => "6276" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Skill and talent" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735786/0000003900000001/v1_201501230116/S2173578614001541/v1_201501230116/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578614001541?idApp=UINPBA00004N" ]
