NOTES, single-port surgery making waves in laparoscopy

Key Points

New technologies that allow single-port transluminal endoscopic surgery will likely draw considerable attention to the area of laparoscopic techniques and technologies at the upcoming AUA annual meeting in Orlando, FL. Because these and other advanced laparoscopic techniques demand considerable surgical skill, advances in surgical education will also be a focal point of this year's meeting.

Elspeth McDougall, MD, professor of urology and director of the Astellas Center for Urological Education at the University of California, Irvine, said she sees a bright future for many of the advanced technologies presented, but a future that has yet to come into sharp focus.

Single-port access (SPA) employs a single incision though which multiple instruments are advanced. Because only one access point is required, scarring can be minimized and may be completely hidden by entering through the patient's navel (ie, keyhole umbilical access).

"SPA is the clinical counterpart of NOTES, and is reasonably feasible," Dr. McDougall said.

Studies being presented at the AUA meeting evaluate the technique as it is employed in a variety of urologic procedures.

"These surgical techniques are going to spawn extensive research into instrumentation and techniques. However, it is still early in their development, and it has yet to be determined if they will replace standard laparoscopy," Dr. McDougall said.

"Just because a procedure is labeled as being less invasive than laparoscopy does not necessarily mean that it is less morbid or more effective than the traditional approach," she cautioned.