Laparoendoscopic single-site surgery (LESS) in gynecology: a multi-institutional evaluation

Fader, Amanda N.; Rojas-Espaillat, Luis; Ibeanu, Okechukwu A.; Grumbine, Francis C.; Escobar, Pedro F.

doi:10.1016/j.ajog.2010.06.028

Cited by 116 publications

(86 citation statements)

References 12 publications

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“…In 2009, Fader and Escobar presented the first 13 cases of LESS for the treatment of various gynecologic oncology conditions (3). Since then, they showed that single-port risk-reducing salpingo-oophorectomy and staging operations were feasible in patients with cancerous conditions (4,5). With the development of optimal instrumentation, it seems that efforts to perform minimally invasive surgery for gynecologic cancers will be continued.…”

Section: Discussionmentioning

confidence: 99%

Two-Port Access Staging Laparoscopy for Gynecologic Cancers

Paek¹,

Kim²

2011

Advanced Gynecologic Endoscopy

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Section: Discussionmentioning

confidence: 99%

Two-Port Access Staging Laparoscopy for Gynecologic Cancers

Paek¹,

Kim²

2011

Advanced Gynecologic Endoscopy

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“…Laparoendoscopic single-site surgery (LESS) has gained world-wide popularity and various surgical procedures including gynecological cancer staging, salpingo-oophorectomy, ovarian cystectomy, laparoscopy assisted vaginal hysterectomy and laparoscopic total hysterectomy have been performed by using LESS [39][40][41][42][43][44]. In LESS procedures, two (or more) conventional ports or a single multichannel device (which enables the passage of instruments and optics) are used through a single incision.…”

Section: Comparison Of Kars With the Previous Surgical Techniquesmentioning

confidence: 99%

Keyless Abdominal Rope-lifting Surgery (KARS)

Alker¹

2012

Surgery

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Ülker, Surgery 2013, S12 http://dx.doi.org/10.4172/2161-1076.S12-007 Research ArticleOpen Access AbstractKeyless Rope-lifting Surgery (KARS) is a novel, single incision, gasless laparoscopic surgery technique. Various operations including adnexal cyst excision, oophorectomy, diagnostic laparoscopy, tubal ligation, hysterectomy and cholecystectomy may be performed through the intra-umbilical transverse incision without using CO 2 pneumoperitoneum and thus the trocars (keyless). In KARS the abdominal cavity is accessed through the 1.5-2 cm intra-umbilical transverse incision. The anterior abdominal wall is elevated by the sutures loaded into the Veress cannula. The elevation creates room for the operations. All operations are performed through the intra-umbilical incision by using laparoscopic and/ or conventional hand instruments. Here in this paper, the KARS techniques and the preliminary results of the specific gynecological procedures are presented.

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“…The existence of learning curves for laparoscopic entry techniques has already been proven, and the incidence of related complications is higher among inexperienced surgeons. Surgeons might experience fewer adverse events if they use the technique with which they are most familiar [85][86][87]. This might also be considered when recommending alternative Veress needle entry sites in obese patients or women with previous abdominal surgery.…”

Section: Study Weaknessesmentioning

confidence: 99%

“…However, more prospective randomized studies will hopefully be published in the near future providing a reliable overview on the technique's safety profile. Whether LESS procedures might be widely accepted will depend on other outcome parameters than just an improved cosmesis: reduced pain, perioperative morbidity, and convalescence could justify both the increased technical demands and the increased costs [85].…”

Section: Study Weaknessesmentioning

confidence: 99%

Entry techniques in gynecologic laparoscopy—a review

et al. 2011

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Laparoscopy is one of the most common surgical procedures in gynecologic medicine. Major complications associated with gynecologic laparoscopy are relatively rare, with up to 50% related to laparoscopic entry. Several entry techniques have been developed, all of which aim to provide a safe and easy entry to the abdominal cavity. In this article, we aim to review the available evidence on laparoscopic entry techniques in gynecologic surgery. We found no evidence that the Hasson (open) technique is superior to the Veress needle entry, the preferred method of most gynecologists all over the world. When entering the abdomen using the Veress needle, an intraperitoneal pressure <10 mmHg is a reliable predictor of correct intraperitoneal placement. Entry at Palmer's point (left upper quadrant laparoscopy) is recommended for patients with suspected or known periumbilical adhesions, or a history or presence of umbilical hernia, or after three failed insufflation attempts at the umbilicus. Recently published trials suggest that direct trocar entry, especially when using optical trocar systems, might be superior to both the Hasson open technique and the Veress needle entry to avoid extraperitoneal insufflation and failed entry. Moreover, blood loss can be reduced and the mean entry time shortened. Laparoscopic entry techniques are still a controversial topic in gynecologic surgery. Many studies are underpowered in order to assess the risk for rare but lifethreatening complications. In conclusion, there is no solid evidence proving the superiority of any method of laparoscopic entry.

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Laparoendoscopic single-site surgery (LESS) in gynecology: a multi-institutional evaluation

Cited by 116 publications

References 12 publications

Two-Port Access Staging Laparoscopy for Gynecologic Cancers

Two-Port Access Staging Laparoscopy for Gynecologic Cancers

Keyless Abdominal Rope-lifting Surgery (KARS)

Entry techniques in gynecologic laparoscopy—a review

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