Skip to main content

LESS: Ports and Instrumentation

  • Chapter
  • First Online:
Scar-Less Surgery

Abstract

A new era in medicine, minimally invasive surgery, has been initiated since the implementation of laparoscopy. As this field evolves, so does the push to further reduce the invasiveness of laparoscopic surgery. To achieve this goal, surgeons have begun limiting the number of abdominal incisions with laparoendoscopic single-site surgery (LESS) or eliminating them completely through natural orifice translumenal endoscopic surgery (NOTES). The latter has been demonstrated primarily in preclinical animal models with limited clinical experience, while LESS has undergone laboratory and clinical work and has proven to be feasible and applicable for human intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Raman JD, Cadeddu JA, Rao P, Rane A. Single-incision laparoscopic surgery: initial urological experience and comparison with natural-orifice transluminal endoscopic surgery. BJU Int. 2008;101:1493–6.

    Article  PubMed  Google Scholar 

  2. Swain P. Nephrectomy and natural orifice translumenal endoscopy (NOTES): transvaginal, transgastric, transrectal, and transvesical approaches. J Endourol. 2008;22:811–8.

    Article  PubMed  Google Scholar 

  3. Gettman MT, Caddedu JA. Natural orifice translumenal endoscopic surgery (NOTES) in urology: initial experience. J Endourol. 2008;22:783–8.

    Article  PubMed  Google Scholar 

  4. Lima E, Rolanda C, Pêgo JM, et al. Third generation nephrectomy by natural orifice transluminal endoscopic surgery. J Urol. 2007;178:648–54.

    Article  Google Scholar 

  5. Gettman MT, Lotan Y, Napper CA, Cadeddu JA. Transvaginal laparoscopic nephrectomy: development and feasibility in the porcine model. Urology. 2002;59:446–50.

    Article  PubMed  Google Scholar 

  6. Kaouk JH, Haber GP, Goel RK, et al. Pure natural orifice translumenal endoscopic surgery (NOTES) transvaginal nephrectomy. Eur Urol. 2009;57:723–6.

    Article  PubMed  Google Scholar 

  7. Raman JD, Bensalah K, Bagrodia A, et al. Laboratory and clinical development of single ­keyhole umbilical nephrectomy. Urology. 2007;70:1039–42.

    Article  PubMed  Google Scholar 

  8. Rane A, Rao P, Bonadio F, Rao P. Single port laparoscopic nephrectomy using a novel laparoscopic port (R-port) and evolution of single laparoscopic port procedure (SLIPP). J Endourol. 2007;21:A87.

    Google Scholar 

  9. White WM, Haber GP, Goel RK, et al. Single-port urological surgery: single-center experience with the first 100 cases. Urology. 2009;74:801–4.

    Article  PubMed  Google Scholar 

  10. Sotelo Noguera RJ, Astigueta JC, Carmona O, et al. Laparoscopic augmentation enterocystoplasty through a single trocar. Urology. 2009;73(6):1371–4.

    Article  Google Scholar 

  11. Ponsky LE, Cherullo EE, Sawyer M, et al. Single access site radical nephrectomy: initial clinical experience. J Endourol. 2008;22:663–6.

    Article  PubMed  Google Scholar 

  12. Stolzenburg JU, Kallidonis P, Hellawell G, et al. Technique of laparo-endoscopic single-site surgery radical nephrectomy. Eur Urol. 2009;56:644–50.

    Article  PubMed  Google Scholar 

  13. Piskun G, Rajpal S. Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A. 1999;9:361–4.

    Article  PubMed  CAS  Google Scholar 

  14. Ghezzi F, Cromi A, Fasola M, et al. One-trocar salpingectomy for the treatment of tubal pregnancy: a “marionette-like” technique. Br J Obstet Gynaecol. 2005;112:1417–9.

    Article  Google Scholar 

  15. Aron M, Canes D, Desai MM, et al. Transumbilical single-port laparoscopic partial nephrectomy. BJU Int. 2008;103:516–21.

    Article  PubMed  Google Scholar 

  16. Gill IS, Canes D, Aron M, et al. Single port transumbilical (E-NOTES) donor nephrectomy. J Urol. 2008;180:637–41.

    Article  PubMed  Google Scholar 

  17. Rane A, Ahmed S, Kommu SS, et al. Single-port “scarless” laparoscopic nephrectomies: the United Kingdom experience. BJU Int. 2009;104:230–3.

    Article  PubMed  Google Scholar 

  18. Ganpule AP, Dhawan DR, Kurien A, et al. Laparoendoscopic single-site donor nephrectomy: a single-center experience. Urology. 2009;74:1238–40.

    Article  PubMed  Google Scholar 

  19. Desai MM, Rao PP, Aron M, et al. Scarless single port transumbilical nephrectomy and pyeloplasty: first clinical report. BJU Int. 2008;101:83–8.

    Article  PubMed  Google Scholar 

  20. Desai MM, Stein R, Rao P, et al. Embryonic natural orifice transumbilical endoscopic surgery (E-NOTES) for advanced reconstruction: initial experience. Urology. 2009;73:182–7.

    Article  PubMed  Google Scholar 

  21. Desai MM, Aron M, Canes D, et al. Single-port transvesical simple prostatectomy: initial clinical report. Urology. 2008;72:960–5.

    Article  PubMed  Google Scholar 

  22. Sotelo RJ, Astigueta JC, Desai MM, et al. Laparoendoscopic single-site surgery simple prostatectomy: initial report. Urology. 2009;74:626–30.

    Article  PubMed  Google Scholar 

  23. Noguera RJ, Astigueta JC, Carmona O, et al. Laparoscopic augmentation enterocystoplasty through a single trocar. Urology. 2009;73:1371–4.

    Article  PubMed  Google Scholar 

  24. White WM, Goel RK, Kaouk JH. Single-port laparoscopic retroperitoneal surgery: initial operative experience and comparative outcomes. Urology. 2009;73(9):1279–82.

    Article  PubMed  Google Scholar 

  25. Saber AA, El-Ghazaly TH, Minnick DB. Single port access transumbilical laparoscopic Roux-en-Y gastric bypass using the SILS Port: first reported case. Surg Innov. 2009;16(4):343–7.

    Article  PubMed  Google Scholar 

  26. Saber AA, El-Ghazaly TH. Early experience with single incision transumbilical laparoscopic adjustable gastric banding using the SILS Port. Int J Surg. 2009;7(5):456–9.

    Article  PubMed  Google Scholar 

  27. Fader AN, Escobar PF. Laparoendoscopic single-site surgery (LESS) in gynecologic oncology: technique and initial report. Gynecol Oncol. 2009;114(2):157–61.

    Article  PubMed  Google Scholar 

  28. Stein RJ, White WM, Goel RK, et al. Robotic laparoendoscopic single-site surgery using GelPort as the access platform. Eur Urol. 2010;57(1):132–6.

    Article  PubMed  Google Scholar 

  29. Ponsky LE, Steinway ML, Lengu IJ, et al. A Pfannenstiel single-site nephrectomy and nephroureterectomy: a practical application of laparoendoscopic single-site surgery. Urology. 2009;74(3):482–5.

    Article  PubMed  Google Scholar 

  30. Park YH, Kang MY, Jeong MS, et al. Laparoendoscopic single-site nephrectomy using a homemade single-port device for single-system ectopic ureter in a child: initial case report. J Endourol. 2009;23:833–5.

    Article  PubMed  Google Scholar 

  31. Ryu DS, Park WJ, Oh TH. Retroperitoneal laparoendoscopic single-site surgery in urology: initial experience. J Endourol. 2009;23:1857–62.

    Article  PubMed  Google Scholar 

  32. Jeong BC, Park YH, Han DH, Kim HH. Laparoendoscopic single-site and conventional laparoscopic adrenalectomy: a matched case–control study. J Endourol. 2009;23:1957–60.

    Article  PubMed  Google Scholar 

  33. Han WK, Park YH, Jeon HG, et al. The feasibility of laparoendoscopic single-site nephrectomy: initial experience using home-made single-port device. Urology. 2010;76(4):862–5.

    Article  PubMed  Google Scholar 

  34. Andonian S, Herati AS, Atalla MA, et al. Laparoendoscopic single-site Pfannenstiel donor nephrectomy. Urology. 2010;75(1):9–12.

    Article  PubMed  Google Scholar 

  35. Stolzenburg JU, Kallidonis P, Oh MA, et al. Comparative assessment of laparoscopic single-site surgery instruments to conventional laparoscopic in laboratory setting. J Endourol. 2010;24(2):239–45.

    Article  PubMed  Google Scholar 

  36. Palanivelu C, Rajan PS, Rangarajan M, et al. NOTES: transvaginal endoscopic cholecystectomy in humans—preliminary report of a case series. Am J Gastroenterol. 2009;104(4):843–7.

    Article  PubMed  Google Scholar 

  37. Horgan S, Cullen JP, Talamini MA, et al. Natural orifice surgery: initial clinical experience. Surg Endosc. 2009;23(7):1512–8.

    Article  PubMed  Google Scholar 

  38. Davila F, Tsin DA, Dominguez G, et al. Transvaginal cholecystectomy without abdominal ports. JSLS. 2009;13(2):213–6.

    PubMed  Google Scholar 

  39. Aron M, Berger AK, Stein RJ, et al. Transvaginal nephrectomy with a multichannel laparoscopic port: a cadaver study. BJU Int. 2009;103(11):1537–41.

    Article  PubMed  Google Scholar 

  40. Sotelo R, de Andrade R, Fernández G, et al. NOTES hybrid transvaginal radical nephrectomy for tumor: stepwise progression toward a first successful clinical case. Eur Urol. 2010;57(1):138–44.

    Article  PubMed  Google Scholar 

  41. Kaouk JH, White WM, Goel RK, et al. NOTES transvaginal nephrectomy: first human experience. Urology. 2009;74(1):5–8.

    Article  PubMed  Google Scholar 

  42. Kaouk JH, Haber GP, Goel RK, et al. Pure natural orifice translumenal endoscopic surgery (NOTES) transvaginal nephrectomy. Eur Urol. 2010;57(4):723–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert J. Stein M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

White, M.A., Stein, R.J. (2013). LESS: Ports and Instrumentation. In: Rane, A., Cadeddu, J., Desai, M., Gill, I. (eds) Scar-Less Surgery. Springer, London. https://doi.org/10.1007/978-1-84800-360-6_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-84800-360-6_4

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84800-359-0

  • Online ISBN: 978-1-84800-360-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics