Editorial Comment

Abstract

Laparoendoscopic single site surgery (LESS) and natural orifice translumenal endoscopic surgery (NOTES) emerged as promising techniques that aim to continue evolution of minimally invasive surgery by attempting to further reduce pain and improve cosmesis of multiport laparoscopy. Recently there seems to be a relative waning of the otherwise heightened enthusiasm with these procedures just a few years ago. LESS/NOTES are still remaining procedures performed by experienced experts in referral centers, used more frequently for extirpative procedures in carefully selected patients. 1 Merseburger A.S. Herrmann T.R. Shariat S.F. et al. EAU guidelines on robotic and single-site surgery in urology. Eur Urol. 2013; 64: 277-291 Abstract Full Text Full Text PDF PubMed Scopus (109) Google Scholar Although there has been improvement to the design of the instruments (longer, prebent and articulated instruments and cameras) that facilitate LESS/NOTES procedures, they are still relatively laborious with suboptimal ergonomics. Continuing refinement of instrumentation and, most importantly, development of purpose-specific robotic platforms may overcome current limitations of LESS/NOTES due to the lack of the triangulation. These may help wider adoption of LESS/NOTES that remain promising techniques waiting for a suitable technology. Hybrid Transvaginal Nephrectomy: Development of Our TechniqueUrologyVol. 84Issue 1PreviewTo evaluate the development of natural orifice transluminal endoscopic surgery (NOTES) transvaginal nephrectomy and present the initial experience. Full-Text PDF ReplyUrologyVol. 84Issue 1PreviewThe technical difficulty of laparoendoscopic single-site surgery (LESS) and natural orifice transluminal surgery (NOTES) hinders their wide acceptance. The development and adoption of new instrument designs have not yet overcome these technical issues. Even the specially designed LESS instruments for robot-assisted LESS face technical problems.1 Nevertheless, the introduction of the special instrumentation for LESS and NOTES may represent one of the greatest contributions of these approaches to minimally invasive surgery. Full-Text PDF