Laparo-endoscopic single-site surgery: preliminary advances in renal surgery

被引:59
作者
Kommu, Sashi S. [1 ]
Kaouk, Jihad H. [2 ]
Rane, Abhay [3 ]
机构
[1] Univ Hosp N Staffordshire, City Gen Hosp, Dept Urol, Stoke On Trent ST4 7LN, Staffs, England
[2] Cleveland Clin Fdn, Sect Laparoscop & Robot Surg, Glickman Urol & Kidney Inst, Cleveland, OH 44195 USA
[3] E Surrey Hosp, Dept Urol, Redhill, Surrey, England
关键词
laparo-endoscopic; single site; surgery; laparoscopy; LESS; NOTES; INITIAL LABORATORY EXPERIENCE; NOTES NEPHRECTOMY; PORCINE MODEL; PORT; UROLOGY;
D O I
10.1111/j.1464-410X.2008.08282.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
We reviewed the preliminary advances in laparo-endoscopic single-site surgery (LESS) as applied to renal surgery, and analyzed current publications based on animal models and human patients. We searched published reports in major urological meeting abstracts, Embase and Medline (1966 to 25 August 2008), with no language restrictions. Keyword searches included: 'scarless', 'scar free', 'single port/trocar/incision', 'intraumbilical', and 'transumbilical', 'natural orifice transluminal endoscopic surgery' (NOTES), 'SILS', 'OPUS' and 'LESS'. The lessons learnt from the studies using the porcine model are that further advances in instrumentation are essential to achieve optimum results, and that testing survival in animals is also necessary to further expand the NOTES and LESS techniques. Further advances in instrument technology together with increasing experience in NOTES and LESS approaches have driven the transition from porcine models to human patients. In the latter, studies show that the techniques are feasible provided that both optimal surgical technical expertise with advanced skills, and optimal instrumentation, are available. The next step towards minimal access/minimally invasive urological surgery is NOTES and LESS. It is inevitable that LESS will be extended to involve more complex and technically demanding procedures such as laparoscopic radical prostatectomy and partial nephrectomy.
引用
收藏
页码:1034 / 1037
页数:4
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