Transumbilical Single-Port Surgery: Evolution and Current Status

被引:323
作者
Canes, David [1 ]
Desai, Mihir M. [1 ]
Aron, Monish [1 ]
Haber, Georges-Pascal [1 ]
Goel, Raj K. [1 ]
Stein, Robert J. [1 ]
Kaouk, Jihad H. [1 ]
Gill, Inderbir S. [1 ]
机构
[1] Cleveland Clin, Glickman Urol & Kidney Inst, Ctr Laparoscop & Robot Surg, Dept Urol, Cleveland, OH 44195 USA
关键词
Laparoscopy; Single port; NOTES; Transumbilical;
D O I
10.1016/j.eururo.2008.07.009
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
Context: Single-port transumbilical laparoscopy, also known as embryonic natural orifice transumbilical endoscopic surgery (E-NOTES), has emerged as an attempt to further enhance cosmetic benefits and reduce morbidity of minimally invasive surgery. Within a short span, several clinical reports have emerged in the urologic literature. As this field is poised to move forward, a complete understanding of its evolution and current status is timely. Objective: To summarize and review the history of E-NOTES across surgical disciplines. This review emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific urological and nonurological applications of single-port surgery to date are summarized. Evidence acquisition: Using the National Library of Medicine database, the English-language literature was reviewed for the past 40 yr. Keyword searches included: scarless, scar free, single port/trocar/incision, intraumbilical, and transumbilical. Within the bibliography of selected references, additional sources were retrieved. Evidence synthesis: The gynecologic and general surgical literature includes approximately 19 papers fulfilling the search criteria, encompassing extirpative procedures only. The urologic literature contains eight published reports of single-trocar transumbilical procedures. These reports are summarized in a chronological manner and grouped by subject. No prospective studies comparing outcomes to standard laparoscopy have been reported. Technical feasibility has been demonstrated for a broad range of extirpative and reconstructive procedures on the upper and lower urinary tracts, including simple and radical nephrectomy, donor nephrectomy, renal cryotherapy, pyeloplasty, ileal ureteral replacement, sacrocolpopexy, and varicocelectomy. Conclusions: E-NOTES has made its initial forays into laparoscopic surgery. Ongoing refinement in technique and instrumentation is likely to expand its future role. (C) 2008 Published by Elsevier B.V. on behalf of European Association of Urology.
引用
收藏
页码:1020 / 1030
页数:11
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