A Transition to Laparoendoscopic Single-Site Surgery (LESS) Radical Prostatectomy: Human Cadaver Experimental and Initial Clinical Experience

Barret, Éric; Sánchez-Salas, Rafael; Kasraeian, Ali; Benoist, Nicolas; Ganatra, Anjali M.; Cathelineau, Xavier; Rozet, François; Galiano, Marc; Vallancien, Guy

doi:10.1089/end.2008.0472

Cited by 58 publications

(28 citation statements)

References 30 publications

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“…The deep cuff was fixed in the peritoneum. The subcutaneous tunnel path and catheter exit site were similar to the previous experience of other studies 4 (Fig. 1c).…”

supporting

confidence: 85%

Single site with multichannel transumbilical laparoscopic implantation of long‐term peritoneal dialysis catheters: Initial clinical experience of two cases

Yang¹,

Liu²,

Sun³

2011

Int J of Urology

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“…The deep cuff was fixed in the peritoneum. The subcutaneous tunnel path and catheter exit site were similar to the previous experience of other studies 4 (Fig. 1c).…”

supporting

confidence: 85%

Single site with multichannel transumbilical laparoscopic implantation of long‐term peritoneal dialysis catheters: Initial clinical experience of two cases

Yang¹,

Liu²,

Sun³

2011

Int J of Urology

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“…Barret et al reported their experience with LESS extraperitoneal RP in a cadaver model [28]. More recently, Boylu et al determined the feasibility, instrumentation, and learning curve for LESS PN in a pig model [29].…”

Section: Clinical Application In Urologymentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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LESS Natural orifice transluminal endoscopic surgery NOTES Robotics UrologyPlease visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery. Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology. Evidence acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology. Evidence synthesis: In urology, NOTES has been completed experimentally via transgastric, transvaginal, transcolonic, and transvesical routes. Initial clinical experience has shown that NOTES urologic surgery using currently available instruments is indeed possible. Nevertheless, because of the immaturity of the instrumentation, early cases have demanded high technical virtuosity. LESS can safely and effectively be performed in a variety of urologic settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low, mostly being small case series or casecontrol studies from selected centers. Thus, the only objective benefit of LESS remains the improved cosmetic outcome. Prospective, randomized studies are largely awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technology advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS and NOTES. Conclusions: NOTES is still an investigational approach in urology. LESS has proven to be immediately applicable in the clinical field, being safe and feasible in the hands of experienced laparoscopic surgeons. Development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

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“…44 Before embarking on their first clinical procedure, Barret et al reported their experience with LESS extraperitoneal radical prostatectomy in a cadaver model, using both standard and articulated laparoscopic instruments. 45 More recently, Boylu et al determined the feasibility, instrumentation, and learning curve for LESS partial nephrectomy in a pig model. The investigators performed 10 transumbilical procedures using the R-Port multichannel port, a 5-mm flexible laparoscope, and custom-engineered articulating needle drivers, graspers, and scissors.…”

Section: Less: Experimental Developmentmentioning

confidence: 99%

“…45 They placed two 8-mm robotic ports and a 12-mm port for the robotic camera into a 4-cm umbilical incision. An additional 5-mm port was placed at the right lower abdomen.…”

Section: Robotics: the Missing Link Towards Scarless Urological Surgery?mentioning

confidence: 99%

Current status and future perspectives in laparoendoscopic single‐site and natural orifice transluminal endoscopic urological surgery

et al. 2010

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Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been succesfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

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A Transition to Laparoendoscopic Single-Site Surgery (LESS) Radical Prostatectomy: Human Cadaver Experimental and Initial Clinical Experience

Abstract: The human cadaver is an adequate model for LESS-RP, and LESS-RARP is feasible to be performed in the clinical arena. The synergy of robotic technology and LESS represents a new generation of surgery.

Cited by 58 publications

References 30 publications

Single site with multichannel transumbilical laparoscopic implantation of long‐term peritoneal dialysis catheters: Initial clinical experience of two cases

Single site with multichannel transumbilical laparoscopic implantation of long‐term peritoneal dialysis catheters: Initial clinical experience of two cases

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Current status and future perspectives in laparoendoscopic single‐site and natural orifice transluminal endoscopic urological surgery

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