Jeffrey A. Cadeddu, MD

A 63-year-old African-American male presents to the emergency department with sudden onset of painless gross hematuria for one day. He reports dark red urine with clots causing occasional dysuria, difficulty emptying, and light-headedness.

In this article, we briefly review the literature suggesting LESS is safe and holds a potential advantage over conventional laparoscopy. We then describe our techniques and outcomes for performing an extirpative (nephrectomy) and reconstructive (pyeloplasty) LESS procedure.