Laparoendoscopic single-site surgery in urologic patients: What does the future hold?

In this article, we briefly review the literature suggesting LESS is safe and holds a potential advantage over conventional laparoscopy. We then describe our techniques and outcomes for performing an extirpative (nephrectomy) and reconstructive (pyeloplasty) LESS procedure.

Review of the current literature

Since these initial reports with modest patient numbers, large, multi-institutional, multinational investigations have demonstrated LESS surgery to be safe with low complication rates (Eur Urol 2011; 60:998-1005; J Urol 2012; 187:1989-94). LESS surgery does not appear to place patients at additional risk compared to conventional laparoscopic operations. Further, there may be a marginal benefit with respect to in-hospital and early postoperative convalescence. The limited benefit of LESS surgery over conventional laparoscopy can be explained by one or more of the following factors: