Surgical Endoscopy

, Volume 26, Issue 9, pp 2671–2677 | Cite as

Ergonomic and geometric tricks of laparoendoscopic single-site surgery (LESS) by using conventional laparoscopic instruments

  • Yao-Chou TsaiEmail author
  • Victor Chia-Hsiang Lin
  • Shiu-Dong Chung
  • Chen-Hsun Ho
  • Fu-Shan Jaw
  • Huai-Ching Tai
Dynamic Manuscript



The aim of this study was to explore the feasibility and safety of performing laparoendoscopic single-site surgery (LESS) with conventional laparoscopic instruments.


We retrospectively reviewed our data from 175 patients who underwent various urological LESS procedures via the same ergonomic and geometric principles between 2008 and 2011. LESS procedures performed included adrenalectomy (N = 23), radical nephrectomy (N = 5), radical nephroureterectomy with bladder cuff resection (N = 5), varicocelectomy (N = 12), nephropexy (N = 4), lumbar sympathectomy (N = 4), orchiectomy for intra-abdominal testis (N = 1), pyeloureterostomy (N = 1), dismembered pyeloplasty (N = 1), and adult inguinal hernia mesh repair (N = 119).


All procedures were completed successfully without the use of ancillary ports or articulating instruments except two cases that required laparoscopic conversion. The mean patient age was 48.9 years. Mean operative time was 99.7 min, mean estimated blood loss was 17.3 ml, and mean hospital stay was 2.1 days. There were no intraoperative complications.


According to our ergonomic and geometric principles, use of conventional laparoscopic instruments is feasible and safe in LESS procedures.


Laparoendoscopic single-site surgery Laparoscopy 



Drs. V. C.-H. Lin, S.-D. Chung, C.-H. Ho, F.-S. Jaw, H.-C. Tai, and Y.-C. Tsai have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MPG 94146 kb)


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Yao-Chou Tsai
    • 1
    • 2
    • 7
    Email author
  • Victor Chia-Hsiang Lin
    • 3
    • 4
  • Shiu-Dong Chung
    • 5
  • Chen-Hsun Ho
    • 2
    • 7
  • Fu-Shan Jaw
    • 1
  • Huai-Ching Tai
    • 6
  1. 1.Institute of Biomedical EngineeringNational Taiwan UniversityTaipeiTaiwan
  2. 2.Department of Urology, Medical CollegeTzu Chi UniversityHualienTaiwan
  3. 3.Department of Urology, E-Da HospitalI-Shou UniversityKaoshiungTaiwan
  4. 4.Institute of Biotechnology and Chemical EngineeringI-Shou UniversityKaoshiungTaiwan
  5. 5.Division of Urology, Department of SurgeryFar Eastern Memorial HospitalBan CiaoTaiwan
  6. 6.Department of UrologyNational Taiwan University HospitalTaipeiTaiwan
  7. 7.Division of Urology, Department of SurgeryBuddhist Tzu Chi General Hospital, Taipei BranchXindianTaiwan

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