The past, present and future of LESS and NOTES

Authors: M. Morgan;  J. A. Cadeddu
Published in: Urol List 2014; 12(2): 52-57


The concept of laparoendoscopic single‑site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) are based on the minimization of skin incision to gain access to the peritoneal cavity to perform surgery. This concept may translate into benefits for patients in terms of recovery time, pain, cosmesis and reduction in port- site complications. Despite the increased interest of these novel approaches worldwide, their claimed advantages have yet to be demonstrated. To overcome the surgical challenges in LESS such as instrument clashing and lack of true triangulation, new technological developments in instrumentation have been designed. The incorporation of novel robotic surgical platforms (R- LESS) have improved the ergonomic challenges and have further advanced LESS surgery. Other promising devices include magnetic anchoring and guidance systems as well as miniature ­in vivo robots that can be placed intra– abdominally and controlled wirelessly. In this article, we review the cur­rent and future innovations LESS and NOTES technology.

Key words:
laparoendoscopic single-site surgery, natural orifice translumenal endoscopic surgery, technology, instrumentation


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