Where Do We Really Stand With LESS and NOTES?

Gettman, Matthew T.; White, Wesley M.; Aron, Monish; Autorino, Riccardo; Averch, Tim; Box, Geoffrey N.; Cadeddu, Jeffrey A.; Canes, David; Cherullo, Edward E.; Desai, Mihir; Frank, Igor; Gill, I.; Gupta, Mantu; Haber, Georges Pascal; Humphreys, Mitchell R.; Irwin, Brian H.; Kaouk, Jihad; Kavoussi, Louis R.; Landman, Jaime; Liatsikos, Evangelos; Lima, Estêvão; Ponsky, Lee; Rané, Abhay; Ribal, María J.; Rabenhalt, Robert; Rao, Pradeep; Richstone, Lee; Sawyer, Mark D.; Sotelo, René; Stolzenburg, J.U.; Tracy, Chad R.; Stein, Robert J.

doi:10.1016/j.eururo.2010.11.016

Cited by 72 publications

(22 citation statements)

References 44 publications

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“…3,4 A litany of new iterations of laparoscopy has been proposed recently, with purported benefits including further reductions in postoperative pain and optimized esthetics. 5 Laparoendoscopic single-site surgery (LESS) uses a single incision through which the abdominal cavity and/or retroperitoneum is entered, the surgical field is exposed, and the diseased organ is directly addressed. 6 Early reports with LESS have cited its feasibility and potential for improved outcomes, particularly cosmesis.…”

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confidence: 99%

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

Autorino

White

Gettman

et al. 2012

Urology

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Evidence relating to the perception and view of patients and physicians on natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) was scrutinized. A comprehensive literature search was performed through PubMed. A total of 18 studies were included in the analysis. Patients demonstrated interest in scarless surgery, with a preference for LESS over NOTES. Safety and efficacy remain the key factors in the decision-making process of patients. With more information about the safety and reproducibility of LESS and NOTES, and with improved educational efforts, patients and physicians alike may feel more comfortable in widespread application of scarless surgery. UROLOGY 80: 495-502, 2012.

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confidence: 99%

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

Autorino

White

Gettman

et al. 2012

Urology

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“…These advantages are even more valuable to patients when reconstructive surgery is performed, given that this is an elective indication that seeks optimal functional results and also that differentially from ablative procedures an incision is often not needed to extract specimens [2]. Improvements in instrumentation and new techniques, such as laparoendoscopic single-site (LESS) surgery, small-caliber minilaparoscopy, and small retroperitoneal access techniques result in diminished trauma to the abdominal wall [3,4]. …”

Section: Introductionmentioning

confidence: 99%

Two-Port Laparoscopic Reconstructive Surgery of the Urinary Tract with Reusable Umbilical System (Hybrid Less): A Proof of Concept Study

Angulo

Pérez²,

García-Tello³

et al. 2016

Urol Int

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Objectives: We compared perioperative results and complications of reconstructive surgery of the urinary tract performed using a multichannel platform through the umbilicus and one additional 3.5-mm with a cohort of patients simultaneously treated with conventional 4-port laparoscopy. Materials and Methods: Matched-pair study comparing perioperative outcomes, postoperative visual analogue pain scale (VAPS) and morbidity of 2-port (n = 20) and 4-port (n = 10) laparoscopic reconstructive urological surgery. Preoperative and perioperative data compared included demographics, type of surgery, operative time, blood loss, decrease in serum hemoglobin, operative complications, length of stay and postoperative complications according to Clavien-Dindo classification. Results: There was no significant difference between groups regarding age, gender, body mass index, American Society of Anesthesiologists score, type of surgery, operative time, operative complications and intraoperative or postoperative transfusion. Estimated blood loss was lower using reduced-port approach. VAPS at postoperative day one was significantly lower for 2-port approach and so was the length of stay. Patient satisfaction with the wound was higher for 2-port surgery. Differences were not observed in number and severity of postoperative complications. Conclusions: Urological reconstructive operations can be safely performed using the hybrid laparoendoscopic single-site umbilical approach, resulting in lower blood loss, higher patient satisfaction and lower postoperative pain, which also facilitate earlier hospital discharge, than the same reconstructive procedures performed through multiport conventional laparoscopy.

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“…Previous extensive abdominal surgery and a BMI (Body Mass Index)> 30 should preclude patients from LESS, especially in the beginning of a center's experience. [3]…”

Section: Methodsmentioning

confidence: 99%

Laparoendoscopic single-site surgery and cancer

et al. 2012

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Objectives:To perform a survey of the current state of laparoendoscopic single-site surgery (LESS) and its implementation in the treatment of malignant disease of the urinary tract. Although it is a recent development in the field of laparoscopic surgery with still unproven long-term results, LESS may prove to be more commonly performed in the coming years while managing urologic cancer patients.Materials and Methods:A PubMed search was conducted using the key words laparoendoscopic single-site surgery, LESS, urologic cancer. Relevant articles were reviewed for data on the management of urologic malignancy with LESS.Results:The first articles describing LESS for urologic cancers were published in 2007. Since then, published experience with this technique has increased. LESS has been implemented as an alternative to conventional laparoscopic surgery and open surgery for the treatment of major urologic cancers. The proposed advantages of LESS are the aesthetic benefit of a single incision and a quicker and less painful recovery. Disadvantages are the lack of instrument triangulation, instrument clashing and the steeper learning curve. As this is a fairly recent technical innovation, long-term functional and oncological results for LESS have not yet been published.Conclusions:LESS is a novel technical advance over conventional laparoscopic surgery, and it can be successfully used in the treatment of patients with urologic cancers. Published data support the feasibility and safety of LESS interventions for major urologic cancers, and newer data may assist in finding LESS's ultimate position among therapeutic options for patients with urologic malignancies.

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Where Do We Really Stand With LESS and NOTES?

Cited by 72 publications

References 44 publications

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

Two-Port Laparoscopic Reconstructive Surgery of the Urinary Tract with Reusable Umbilical System (Hybrid Less): A Proof of Concept Study

Laparoendoscopic single-site surgery and cancer

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