Transumbilical Single-Port Surgery: Evolution and Current Status

Canes, David; Desai, Mihir; Aron, Monish; Haber, Georges-Pascal; Goel, Raj Kumar; Stein, Robert J.; Kaouk, Jihad; Gill, Inderbir S.

doi:10.1016/j.eururo.2008.07.009

Cited by 377 publications

(264 citation statements)

References 21 publications

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“…New laparoscopic access devices, optics, and instrumentation specifically designed for successfully facilitating LESS have been developed in the last few years [13,[30][31][32] (Table 3).…”

Section: 2mentioning

confidence: 99%

“…Articulating instruments have been developed to allow the surgeon's hands to be positioned apart from each other while maintaining the tips of the instruments still focused on the same point inside the abdomen. A combination of conventional and flexible (articulating) instruments provides improved intraoperative ergonomics [13,[30][31][32]. Traditional rigid, straight instruments have also been used for LESS.…”

Section: Instrumentsmentioning

confidence: 99%

“…Thus, the ideal telescope for LESS should remove the light cord and camera head from the operative field. Low-profile camera systems have been introduced for this purpose [15,[30][31][32].…”

Section: Opticsmentioning

confidence: 99%

“…Unfortunately, the quality of evidence of all available studies remains low, mostly being small case series [61][62][63] (evidence level 4) or case-control studies from selected centers [64][65][66][67][68][69][70][71] (evidence level 3b). Given the limited amount of data, available reviews are narrative [11,13,14,[29][30][31]78,79] or are based on expert opinions and consensus meetings [1,2,80] (evidence level 4). Thus far, the advantages of LESS still exist at a theoretical level, because no clear benefit on postoperative course and patient convalescence has been definitively proven.…”

Section: 4mentioning

confidence: 99%

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Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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LESS Natural orifice transluminal endoscopic surgery NOTES Robotics UrologyPlease visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery. Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology. Evidence acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology. Evidence synthesis: In urology, NOTES has been completed experimentally via transgastric, transvaginal, transcolonic, and transvesical routes. Initial clinical experience has shown that NOTES urologic surgery using currently available instruments is indeed possible. Nevertheless, because of the immaturity of the instrumentation, early cases have demanded high technical virtuosity. LESS can safely and effectively be performed in a variety of urologic settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low, mostly being small case series or casecontrol studies from selected centers. Thus, the only objective benefit of LESS remains the improved cosmetic outcome. Prospective, randomized studies are largely awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technology advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS and NOTES. Conclusions: NOTES is still an investigational approach in urology. LESS has proven to be immediately applicable in the clinical field, being safe and feasible in the hands of experienced laparoscopic surgeons. Development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

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“…New laparoscopic access devices, optics, and instrumentation specifically designed for successfully facilitating LESS have been developed in the last few years [13,[30][31][32] (Table 3).…”

Section: 2mentioning

confidence: 99%

Section: Instrumentsmentioning

confidence: 99%

Section: Opticsmentioning

confidence: 99%

Section: 4mentioning

confidence: 99%

See 2 more Smart Citations

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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“…En 2008, el grupo de Gill revisó no sólo la nomenclatura y el diferente instrumental disponible en ese momento, sino también todas las cirugías realizadas por e-NOTES (hoy se incluiría en el término U-LESS) publicadas hasta la fecha 17 . La experiencia en las diversas especialidades era discreta; las indicaciones más comunes eran la ligadura de trompas, la apendicectomía y la colocación intraperitoneal de catéteres de diálisis.…”

Section: Actas Urológicas Españolasunclassified