Abstract

AZEVEDO, Luís. Laparoendoscopic single-site surgery: past, present and future. Arq Med [online]. 2013, vol.27, n.6, pp.256-264. ISSN 2183-2447.

Introduction: laparoendoscopic single-site surgery (LESS) is a surgical technique that consists of an umbilical incision with insertion of all instruments through it, promising better cosmetic results, less post-operative pain and recovery time. Despite existing since the 70s, only recently instruments capable of overcoming the obstacles encountered initially, such as triangulation difficulties and instrument clashing, started being developed. Aim: to make a review of the literature available on LESS, establish its safety and efficacy comparing it with conventional laparoscopy, point out the difficulties found and make an evaluation of the possible applications of this technique in the future. Methods: pubmed was initially searched for the keywords “single-incision”, “single-port” and “single-site” and some articles were used for the introduction, pointing out problems and solutions and to structurize the rest of the review; then the keywords “ robotic”, “cholecystectomy”, “appendectomy”, “appendicectomy”, “colorectal”, “colonic”, “colectomy”, “gynecology”, “hysterectomy”, “urology” and “nephrectomy” were added and preference was given to systematic reviews, meta-analysis and randomized clinical trials published after 2010. conclusion: this technique is still in its infancy, yet there are millions of cases in the literature already that show it to be as safe as the conventional techniques, and prove the promised benefits. one should take into account that negative results may not yet have been published, and that the described cases in the literature were performed by very experienced and motivated laparoscopists. More randomized clinical trials are needed to define the role of this technique in the future, now being used in investigational context.

Keywords : Laparoendoscopic single-site surgery; conventional laparoscopy; literature review.

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