The Role of NOTES and LESS in Minimally Invasive Reconstructive Urological Surgery

  • Mark D. Sawyer
  • Lee PonskyEmail author
Part of the Current Clinical Urology book series (CCU)


Natural orifice translumenal endoscopic surgery (NOTES™) and laparoendoscopic single-site surgery (LESS) are exciting new developments in the evolution of minimally invasive surgery with potential application to urologic reconstructive surgery. Both represent a natural progression of laparoscopic surgery with ever fewer and smaller incisions and each shares common challenges. NOTES™ as a concept offers the potential for surgery without any transcutaneous abdominal incisions. LESS appears to offer a natural intermediate step toward a NOTES™ approach and may prove more practical for many applications. LESS may be described as a laparoscopic procedure with a single cutaneous incision through which multiple trocars or ports are placed. The advantages of either approach relative to standard laparoscopy will need to be established. There are rapid technological advances that are propelling both approaches forward, making an exhaustive description of the techniques and equipment unfeasible.


NOTES (natural orifice translumenal endoscopic surgery) LESS (laparoendoscopic single-site surgery) Single-site surgery Minimally invasive surgery Endoscopic surgery 

Supplementary material

Natural Orifice Translumenal Endoscopic Surgery (NOTES™) and Laparoendoscopic Single-Site Surgery (LESS) in Reconstructive Urology (59.8 MB)


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of Orologic Oncology, Department of UrologyCenter of Urologic Oncology and Minimally Invasive Therapies, University Hospitals Case Medical CenterClevelandUSA

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