Department of Surgery, University of California San Diego, USA.
BJU Int. 2010 Sep;106(6 Pt B):934-40. doi: 10.1111/j.1464-410X.2010.09673.x.
A combination of refinements in laparoscopic instrumentation and increasing surgical experience has driven innovation in the area of laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). By combining working ports and the extraction incision into one site, LESS allows access to the peritoneum with fewer incisions and less scarring than the traditional multiport laparoscopic technique. Reduced incisional morbidity and improved cosmesis have sparked a growing interest in the utilization of these techniques to perform urological surgery. Mastering of the technique requires training and repetition to develop the muscle memory required to perform these challenging procedures. Although there has been an explosion of literature published about initial experiences with LESS and NOTES, little has been written about training and implementation of this approach. Here, we describe our institutional experience and the essential elements of a LESS and NOTES training curriculum and offer some insight into establishing a successful programme.
腹腔镜器械的改进和手术经验的增加推动了单孔腹腔镜手术（LESS）和经自然腔道内镜手术（NOTES）领域的创新。LESS 通过将工作端口和提取切口组合到一个部位，与传统的多孔腹腔镜技术相比，LESS 可以通过更少的切口和更少的疤痕进入腹膜。减少切口发病率和改善美容效果激发了人们对利用这些技术进行泌尿外科手术的兴趣。掌握这项技术需要培训和重复，以形成执行这些具有挑战性手术所需的肌肉记忆。尽管已经有大量关于 LESS 和 NOTES 初步经验的文献发表，但关于该方法的培训和实施却很少有报道。在这里，我们描述了我们机构的经验以及 LESS 和 NOTES 培训课程的基本要素，并就建立一个成功的项目提供了一些见解。
