Department of Urology, University of Greifswald, Greifswald, Germany.
World J Urol. 2012 Oct;30(5):573-80. doi: 10.1007/s00345-012-0899-9. Epub 2012 Jul 13.
Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) are the next steps in the evolution of laparoscopic surgery, promising reduced morbidity and improved cosmetic result. The inconsistent terminology initially used led to confusion. Understanding the technical evolution, the current status and a unified and simplified terminology are key issues for further acceptance of both approaches.
To present LESS and NOTES in its historical context and to clarify the associated terminology.
Extensive literature search took place using the PubMed. Several hundred publications in general surgery and urology regarding LESS are present including the expert opinion of members the European Society of Uro-technology (ESUT).
The increasing interest on NOTES and LESS is reflected by a raising number of publications during the last 4 years. The initial confusion with the terminology of single-incision surgery represented a significant issue for further evolution of the technique. Thus, consortiums of experts searched a universally acceptable name for single-incision surgery. They determined that 'laparoendoscopic single-site surgery' (LESS) was both scientifically accurate and colloquially appropriate, the term being also ratified by the NOTES working group (Endourological Society) and the ESUT. For additional use of instruments, the terms hybrid NOTES and hybrid LESS should be used. Any single use of miniaturized instruments for laparoscopy should be called mini-laparoscopy.
The evolution of LESS and most likely NOTES to a new standard of minimally invasive surgery could represent an evolutionary step even greater than the one performed by the establishment of laparoscopy over open surgery.
经自然腔道内镜手术（NOTES）和经脐单孔腹腔镜手术（LESS）是腹腔镜手术发展的下一步，有望减少发病率和改善美容效果。最初使用的不一致术语导致了混淆。理解技术的演变、当前的状况以及统一和简化的术语是进一步接受这两种方法的关键问题。
在历史背景下介绍 LESS 和 NOTES，并澄清相关术语。
使用 PubMed 进行了广泛的文献搜索。在普通外科和泌尿科有几百篇关于 LESS 的出版物，包括欧洲泌尿外科技师协会（ESUT）成员的专家意见。
在过去的 4 年中，NOTES 和 LESS 的日益关注反映在出版物数量的增加上。最初，由于单一切口手术术语的混淆，是该技术进一步发展的一个重大问题。因此，专家联盟寻找了一个普遍可接受的单一切口手术名称。他们确定“经脐单孔腹腔镜手术”（LESS）既具有科学准确性，又具有通俗性，该术语也得到了NOTES 工作组（内镜学会）和 ESUT 的认可。对于额外使用器械，应使用混合 NOTES 和混合 LESS 术语。任何用于腹腔镜的小型化器械的单一使用都应称为迷你腹腔镜。
LESS 和最有可能的 NOTES 向微创外科的新标准的发展可能代表了一个进化步骤，甚至比腹腔镜手术对开放手术的建立所带来的进化步骤更大。
