Current status of natural orifice trans-endoscopic surgery (NOTES) and laparoendoscopic single site surgery (LESS) in urologic surgery

Sánchez-Salas, Rafael; Barret, Éric; Watson, John; Stakhovskyi, O.; Cathelineau, Xavier; Rozet, François; Galiano, Marc; Rané, Abhay; Desai, Mihir; Sotelo, René; Vallancien, Guy

doi:10.1590/s1677-55382010000400002

Cited by 16 publications

(7 citation statements)

References 66 publications

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“…LESS has been an important step on the road towards ‘scarless' laparoscopic surgery and has been the motive for the development of new techniques and improvement in laparoscopic instruments [4,5,12,13]. LESS nephrectomy has been established as an alternative to laparoscopy [1,13] while procedures requiring complex suturing and reconstructive tasks are still associated with limited experience and are feasible only in the hands of experienced laparoscopic surgeons [14,15].…”

Section: Discussionmentioning

confidence: 99%

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‘Scarless' Laparoscopic Urologic Surgery by the Combination of Mini-Laparoscopic and Laparoendoscopic Single-Site Surgery Equipment

Kallidonis

Georgiopoulos²,

Kyriazis³

et al. 2014

Urol Int

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Objective: We evaluated reconstructive and oncological laparoendoscopic single-site surgery (LESS) combined with mini-laparoscopic instruments as standard equipment. Patients and Methods: 30 patients underwent reconstructive and oncological LESS: mini-laparoscopic-assisted LESS pyeloplasty (LESS-P, n = 18), mini-laparoscopic-assisted LESS partial nephrectomy (LESS-PN, n = 7) or mini-laparoscopic-assisted LESS radical prostatectomy (LESS-RP, n = 5). Perioperative data were prospectively collected. Results: The 18 LESS-P cases had operative times ranging between 120 and 180 min (average 147.9 min). Estimated blood loss ranged between 100 and 300 ml (average 202.1 ml). Two patients required additional management for failed reconstruction. LESS-PN was performed in 7 patients with tumor size ranging between 2.5 and 3.8 cm (average 2.7 cm). Average operative time and blood loss were 155 (140-180) min and 321.4 (250-550) ml, respectively. Renal artery clamping took place in 1 case. LESS-RP was performed in 5 patients; average operative time was 156 (140-180) min and average blood loss 196 (100-400) ml. Functional and oncological outcome was directly comparable to laparoscopic radical prostatectomy. Conclusion: The combination of LESS and mini-laparoscopic instrumentation as routine equipment of reconstructive LESS reveals a different perspective for ‘scarless' urologic surgery.

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Section: Discussionmentioning

confidence: 99%

“…LESS nephrectomy has been established as an alternative to laparoscopy [1,13] while procedures requiring complex suturing and reconstructive tasks are still associated with limited experience and are feasible only in the hands of experienced laparoscopic surgeons [14,15]. …”

Section: Discussionmentioning

confidence: 99%

‘Scarless' Laparoscopic Urologic Surgery by the Combination of Mini-Laparoscopic and Laparoendoscopic Single-Site Surgery Equipment

Kallidonis

Georgiopoulos²,

Kyriazis³

et al. 2014

Urol Int

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“…This infl uences the cosmetic effect and besides, a hernia in the scar may occur. In this case, there is only little difference between the hybrid NOTES technique and the technique of single port incision laparoscopy (SILS technique) which means a variant of classic laparoscopy using only one approach into the abdominal cavity (25,26,27).…”

Section: Discussionmentioning

confidence: 99%

Natural oriffice transluminal endoscoping surgery – transgastric approach

Šmíd¹,

Moláček²,

Veselý³

et al. 2012

BLL

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Abstract:Background: Natural Oriffi ce Transluminal Endoscopic Surgery (NOTES) is a newly developed miniinvasive surgical method for ensuring an approach into the abdominal cavity through the wall of the organ being accessible to the endoscopic examination. We can use the transcolonic, as the case may be, transrectal, transvaginal or transgastric approach Methods: We performed the experiment in thirty pigs which were divided into two groups. In the fi rst group, we performed pure NOTES exploration of the abdominal cavity with the transgastric approach, the formed defect of the stomach was closed by the OTSC clip. In the other controlled group, a classic laparoscopic exploration of the abdominal cavity was performed. Ultrasonography of the abdominal cavity, assessment of infl ammatory parameters and clinical monitoring of the animals clinically were performed regularly postoperatively . After two weeks, the animals were put to death and an autopsy was done. The results of both groups were mutually compared, focusing on safety of the gastrotomy closure and the occurence of infectious complications. Results: No serious postoperative infectious complications were observed in both groups, the closure of the defect of the stomach wall was always suffi cient. The other monitored results were comparable. Conclusion: Using the OTSC clip is a safe choice of the gastrotomy closure. It is supposed to be used in limited cases, also if perforation of the digestive tube is being solved. Nowadays, using the NOTES technique as a surgical method in the abdominal cavity is not suitable (Tab. 2, Fig. 3, Ref. 27). Full Text in PDF www.elis.sk.

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“…The pelvic cavity hosts a number of important organs that are suitable to receive surgical treatment for both benign and malignant diseases. Laparoscopic surgery is increasingly used as an alternative to laparotomy, and more recently the evolution of surgery has brought up the concept of LESS . No papers are published in the literature about pelvic NOTES urological surgery …”

Section: Notes In Pelvic Surgerymentioning

confidence: 99%

Recent advances of natural orifice transluminal endoscopic surgery in urological surgery

et al. 2013

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Abbreviations & AcronymsAbstract: Natural orifice transluminal endoscopic surgery designates a surgical procedure that utilizes one or more patent natural orifices of the body with the intention to puncture a hollow viscera in order to enter the abdominal cavity. First carried out at the beginning of the 2000s in experimental models, it can be considered the natural evolution of laparoscopy towards the ideal of scarless surgery, as the avoidance of a large abdominal scar is associated with better cosmetic results and better recovery. However, the technology currently available does not allow the performance of complete pure natural orifice transluminal endoscopic surgery procedures. The surgical tools used are not specially designed for this approach, so difficulties in retracting organs, bleeding control and clashing of instruments are the main obstacle surgeons face. For this reason, the current available technique is the so-called hybrid approach, where a natural orifice approach is combined with some abdominal trocars, using the natural orifice as the exit door for the specimen removal. As not many comparative studies have been published evaluating the advantages of natural orifice transluminal endoscopic surgery in front of traditional laparoscopic surgery, a review of the history of natural orifice transluminal endoscopic surgery, and an assessment of the available evidence of this technique regarding renal and urological pelvic surgery are performed in this article.

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Current status of natural orifice trans-endoscopic surgery (NOTES) and laparoendoscopic single site surgery (LESS) in urologic surgery

Cited by 16 publications

References 66 publications

‘Scarless' Laparoscopic Urologic Surgery by the Combination of Mini-Laparoscopic and Laparoendoscopic Single-Site Surgery Equipment

‘Scarless' Laparoscopic Urologic Surgery by the Combination of Mini-Laparoscopic and Laparoendoscopic Single-Site Surgery Equipment

Natural oriffice transluminal endoscoping surgery – transgastric approach

Recent advances of natural orifice transluminal endoscopic surgery in urological surgery

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