The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Ther Adv Urol. 2009 Dec;1(5):259-66. doi: 10.1177/1756287210364960.
Since its introduction, the role of laparoscopic surgery has grown and it has now become the standard approach for many surgical procedures. The benefits of smaller incisions, improved pain and convalescence, and shorter hospital stays have greatly improved patient care and satisfaction. In an effort to further minimize the morbidity of surgery, laparoendoscopic single-site (LESS) or single-incision laparoscopic surgery (SILS) has emerged. We review the collective experience with this novel technique and share our initial observations and early results.
We performed a literature search to review the published experience with this new technique including the breadth of applications and perioperative outcomes associated with LESS in urology. We also analysed the experience with this emerging technique at our institution.
There are numerous variations with regards to nomenclature as well as types of access to the abdominal cavity as it pertains to LESS. Urologic procedures involving single-port access have acceptable operating room time, blood loss, and postoperative pain, which are in line with standard laparoscopic surgical outcomes with the added benefit of improved cosmesis and smaller incisions.
Further studies and larger cohorts are needed to assess the real benefit of LESS procedures. The additional learning curve needed to master these techniques may be a barrier to wider acceptance, although improvements in instrumentation are likely to bridge this gap.
自引入以来，腹腔镜手术的作用不断扩大，现已成为许多外科手术的标准方法。较小的切口、改善的疼痛和康复情况以及更短的住院时间极大地提高了患者的护理和满意度。为了进一步降低手术的发病率，出现了经腹腔镜单部位（LESS）或单切口腹腔镜手术（SILS）。我们回顾了这项新技术的集体经验，并分享了我们的初步观察结果和早期结果。
我们进行了文献检索，以回顾该新技术的发表经验，包括LESS 在泌尿外科中的广泛应用和围手术期结果。我们还分析了我们机构中使用这种新兴技术的经验。
关于LESS 的命名以及进入腹腔的方式有很多种变化。涉及单端口进入的泌尿科手术具有可接受的手术室时间、出血量和术后疼痛，与标准腹腔镜手术结果一致，具有改善美容效果和更小切口的额外益处。
需要进一步的研究和更大的队列来评估LESS 手术的真正益处。掌握这些技术所需的额外学习曲线可能是更广泛接受的障碍，尽管器械的改进可能会弥合这一差距。
