Laparoendoscopic Single-Site (LESS) Surgery and Robotic Laparoendoscopic Single-Site (R-LESS) Surgery in Urology: Adult and Pediatric Applications

The adaptation of minimally invasive surgery for adult and pediatric urologic procedures has grown exponentially over the past few decades. With continued technological advances and reduction in the number of ports, laparoscopic procedures have been associated with shorter hospital stays, improved cosmesis, and reduced postoperative pain medication requirements. Laparoendoscopic single-site (LESS) surgery represents a continuation of the evolution toward the goal of "virtually scarless" surgery, where the number of port sites is reduced to a single incision. LESS surgery has been shown to be feasible in a wide array of urologic procedures in both adults and children. Early comparative studies are beginning to show similar perioperative outcomes for conventional laparoscopic and LESS procedures. Although a learning curve is present with regard to techniques and instrumentation as adult and pediatric urologic surgeons adapt to these novel LESS procedures, the learning curve for the experienced laparoscopic surgeon appears to be short as surgeon's experience with the new technology grows. Experience in robotic LESS (R-LESS) surgery is also growing to address the technical difficulties associated with LESS surgery.