Document Detail

[Current state of single-port transumbilical surgery in urology: challenges and applications].
MedLine Citation:
PMID:  22999345     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Laparoscopic surgery in urology is considered to be an important advance, although it is not exempt from some morbidity associated to the use of multiple trocars and specifically to the extraction of the specimen. In order to decrease this morbidity and improve esthetics, other techniques are being developed, such as natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). It is aimed to review the current status of laparoendoscopic single site surgery in urology.
ACQUISITION OF EVIDENCE: A nonsystematic review has been carried out by means of the bibliographic search using the terms LESS and Urology from 2007 to 2012. The current LESS experience in urology is described, and its principal indications and the different single site devices and instruments available on the market are described.
SYNTHESIS OF EVIDENCE: LESS surgery arose as one more step in the constant evolution of minimally invasive surgery in an attempt to improve esthetics, reduce surgical trauma and decrease pain and the post-operative complications associated to the conventional laparoscopy with multiple trocars. Since it was first described in 2007, the experience has been increasing exponentially and the LESS technique, whether assisted or not by robot, is becoming consolidated for a large spectrum of urological indications (both in oncological and reconstructive surgery) on a much greater scale than the NOTES technique. Even though most of the existing data are not randomized and very rarely comparative, with the selection bias that this represents, it seems clear that the esthetic benefit and analgesic control associated to the LESS surgery is real and reproducible. The complications associated to it are greater in cases of major oncology surgery and are due more to the technique itself then to the approach.
CONCLUSIONS: Although the real benefit of the LESS surgery in urology cannot be appropriately quantified, the cosmetic improvement, less pain and greater patient satisfaction with their wound are clear. Appropriate training in this type of procedures in centers having large volumes and the continuous technical improvements in the instrumental development by the biomedical industry has resulted in the fact that the transumbilical LESS technique in urology has been born to stay.
J M García-Mediero; P M Cabrera; F Cáceres; E Mateo; A García-Tello; J C Angulo
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Publication Detail:
Type:  English Abstract; Journal Article; Review     Date:  2012-09-20
Journal Detail:
Title:  Actas urologicas españolas     Volume:  37     ISSN:  1699-7980     ISO Abbreviation:  Actas Urol Esp     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-22     Completed Date:  2014-08-25     Revised Date:  2014-11-13    
Medline Journal Info:
Nlm Unique ID:  7704993     Medline TA:  Actas Urol Esp     Country:  Spain    
Other Details:
Languages:  spa     Pagination:  106-13     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 AEU. Published by Elsevier España. All rights reserved.
Vernacular Title:
Estado actual de la cirugía transumbilical por puerto único en urología: retos y aplicaciones.
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MeSH Terms
Equipment Design
Laparoscopy* / instrumentation
Natural Orifice Endoscopic Surgery / instrumentation,  methods*
Urologic Surgical Procedures / instrumentation,  methods*

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