Public Perception of “Scarless” Surgery: A Critical Analysis of the Literature

Abstract

Evidence relating to the perception and view of patients and physicians on natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) was scrutinized. A comprehensive literature search was performed through PubMed. A total of 18 studies were included in the analysis. Patients demonstrated interest in scarless surgery, with a preference for LESS over NOTES. Safety and efficacy remain the key factors in the decision-making process of patients. With more information about the safety and reproducibility of LESS and NOTES, and with improved educational efforts, patients and physicians alike may feel more comfortable in widespread application of scarless surgery. UROLOGY 80: 495-502, 2012.

Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre

“…In addition to safety and efficacy as the most important factors, the cosmetic consequences of a procedure are also important in surgical treatment decision making. This is especially true for younger patient groups [5,10].…”

“…The number of novel surgical procedures performed is dictated by patient demand and their perception of the techniques. The establishment of a gold standard for one of the first intricate MIS procedures, laparoscopic cholecystectomy, was mainly driven by the public [5]. In addition to safety and efficacy as the most important factors, the cosmetic consequences of a procedure are also important in surgical treatment decision making.…”

“…Currently, orchidopexy, partial nephrectomy, and ureteral reimplantation are widely performed in paediatric urology. Laparoscopic retroperitoneal and transperitoneal pyeloplasty is believed to be the gold standard procedure, and patients are increasingly requesting 'keyhole' surgery [5].…”

Retropubic, laparoscopic and mini-laparoscopic radical prostatectomy: a prospective assessment of patient scar satisfaction

“…In a recent review on public perception of scarless surgery, Autorino et al [5] showed that safety and efficacy are as the primary surgical outcomes for patients while scar issue is such significant just when equivalence results and risks are assured. In a prospective comparative study, Porpiglia et al showed that patients who underwent minilaparoscopic pyeloplasty were significantly more satisfied with their cosmetic result than those who had standard laparoscopic approach [8].…”

“…Based on this concept, novel surgical approaches such as natural orifice translumenal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been explored [5]. However, these techniques carry some limitations, including an unfavorable ergonomy and the lack of optimal instrumentation, are still under development.…”