Korean J Urol.  2012 Jul;53(7):443-450. 10.4111/kju.2012.53.7.443.

Current Status of Laparoendoscopic Single-Site Surgery in Urologic Surgery

• Oh TH

• KMID: 1988753
• DOI: http://doi.org/10.4111/kju.2012.53.7.443

Abstract

Since the introduction of laparoscopic surgery, the promise of lower postoperative morbidity and improved cosmesis has been achieved. Laparoendoscopic single-site surgery (LESS) potentially takes this further. Following the first human urological LESS report in 2007, numerous case series have emerged, as well as comparative studies comparing LESS with standard laparoscopy. However, comparative series between conventional laparoscopy and LESS for different procedures suggest a non-inferiority of LESS over standard laparoscopy, but the only objective benefit remains an improved cosmetic outcome. Challenging ergonomics, instrument clashing, lack of true triangulation, and in-line vision are the main concerns with LESS surgery. Various new instruments have been designed, but only experienced laparoscopists and well-selected patients are pivotal for a successful LESS procedure. Robotic-assisted LESS procedures have been performed. The available robotic platform remains bulky, but development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

Keyword

Laparoscopy; Minimally invasive surgical procedures; Robotics

MeSH Terms

Cosmetics
Human Engineering
Humans
Laparoscopy
Robotics
Surgical Procedures, Minimally Invasive
Vision, Ocular
Cosmetics

Figure

• 

  FIG. 1 Stepping forward: from laparoendoscopic single-site surgery (LESS) to R-LESS (Robotic-LESS) (modified from Rane and Autorino. Curr Opin Urol 2011;21:71-7, with permission of Wolters Kluwer) [52]. 2D, 2 dimensions; HD, high definition.

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