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6 (2.6)?days. The patients�� demographic and perioperative data are shown in Table 1. The pathological examination of the urinary bladder specimens showed negative surgical margins in all 10 patients. The histopathological examination showed pT1N0M0 in one case, pT2bN0M0 in four, pT3aN0M0 in four, and pT3bN1M0 in one. The mean (SD, range) number of lymph nodes retrieved was 14 (1.9, 11�C17), and they were SCH772984 supplier negative for all patients except one, in whom the RC was converted to open surgery. Within a mean (SD, range) follow-up of 37 (6, 29�C44)?months, seven patients remained free of cancer. One patient developed liver and bone metastases at 11?months (patient 7), one was missing from the follow-up after 18?months (patient 10), and another patient (No. 2) died in a traffic accident after 13?months. LESS surgery is being developed in urology [6], and although LESS-RC seemed to be more technically challenging and longer than conventional laparoscopy, it still provides the advantages of laparoscopy, with fewer transcutaneous incisions. Accordingly, it would be expected to result in less postoperative pain, a better convalescence and a better cosmetic outcome than laparoscopic RC. Kaouk et al. [7] reported their first three cases of LESS-RC with an ileal conduit diversion, with a mean (SD) operative duration of 315 (40)?min, a mean blood loss of 217 (29)?mL and a mean hospital stay Amrinone of 6 (1)?days. In the present series, the operative duration, blood loss and hospital stay were comparable with those reported by Kaouk et al., despite the complexity of the method of diversion used in our series (all the patients had an orthotopic urinary diversion). More recently, Ma et al. [8] reported a series of LESS-RC in five patients, using a home-made single-port device, with a mean operative duration of 208.2?min, a mean blood loss of 270?mL, and a mean postoperative hospital stay of 19.5?days. Similarly, the present results are comparable for operative duration and blood loss, despite the simplicity of the method of urinary diversion that MA et al. used in their five cases. Technically, LESS-RC is difficult Bortezomib concentration to learn, involving co-ordination between the surgeon and the camera holder, navigating the instruments within a limited range of motion, and counterintuitive movements. The most remarkable finding in the present study is the smooth postoperative course. The visual-analogue pain score in all patients was