Purpose: The goal of this report is to describe our initial clinical experience performing a simple nephrectomy with the SPIDER (Single Port Instrument Delivery Extended Reach) laparoendoscopic single-site (LESS) surgical system. Patient and Methods: One patient with a nonfunctioning kidney secondary to a ureteropelvic junction obstruction underwent a simple nephrectomy through a single incision performed using the SPIDER surgical system. We assessed the technical feasibility, efficiency, and perioperative outcomes. Results: The SPIDER-LESS nephrectomy was performed successfully without additional skin incisions for laparoscopic ports, instrument clashing, or open conversion. Total operative time was 210 minutes with blood loss of 50 mL. The patient experienced no intraoperative or postoperative complications. Pathologic evaluation confirmed atrophic renal parenchyma. Conclusions: The SPIDER surgical system LESS nephrectomy is feasible and safe. Future refinements of the technology and prospective studies are needed to further optimize its application in urology.
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