Laparoendoscopic single-site surgery (LESS) in urology - a new frontier in minimally invasive surgery?
Abstract
Aim: The objective of this article is to present the recent development and literature rewiev on laparoendoscopic single-site surgery (LESS) in urology. Method: In 2007 studies were published using small cohorts and were plagued by technical problems such as insufficient instruments and ports.
To advance the technique of minimally invasive laparoscopy further development of new adapted instrumentation (multiluminal ports, flexibile and prebent instruments, modified optics) was needed. Currently a large number of new accessories for LESS technique is available.
The LESS procedures are most commonly performed on the upper urinary tract. These include radical nephrectomy, renal cyst ablation and simple nephrectomy for non-functional kidney.
Conclusion: LESS represents an advancement in minimally invasive urological surgery. It has proven to be a feasible and safe method used in a broad range of procedures.
LESS is indicated for selected patients with a low body mass index and in cases where a small specimen is extracted. A successful procedure requires an experienced laparoscopic surgeon and assistant.
Prospective multicenter clinical studies comparing LESS with conventional laparoscopy are necessary to establish the benefits of this procedure and to evaluate indication criteria.