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Laparo-endoscopic single-site surgery

Maria Luisa Gasparri, Michael D Mueller, Katayoun Taghavi, Andrea Papadia
BACKGROUND/AIMS: A new minimally invasive laparoscopic approach for ectopic pregnancy, the laparo-endoscopic single site surgery (LESS), has recently been introduced. The aim of this study is to compare the surgical outcome of this approach with conventional laparoscopy for ectopic pregnancy. METHOD: A review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement was performed. Electronic databases PubMed, MEDLINE, and Scopus were searched in December 2017 by searching the terms "single port laparoscopy" or "laparoendoscopic single site-surgery" or "single site laparoscopy" or "single-incision laparoscopic surgery" and "ectopic pregnancy...
April 17, 2018: Gynecologic and Obstetric Investigation
S García-Martínez, M A Sánchez-Hurtado, H Gutiérrez, F M Sánchez-Margallo, R Romar, R Latorre, P Coy, O López-Albors
STUDY QUESTION: Is O2 tension in the pig oviduct and uterus affected by the estrous cycle stage and the animal's age, and can the outcome of in vitro embryo development be improved by mimicking these physiological values? SUMMARY ANSWER: O2 tension within the pig reproductive organs is affected by the animal's age, and values close to those measured in vivo have a positive impact on embryo development and quality when used during IVF and embryo culture (EC). WHAT IS KNOWN ALREADY: To obtain a healthy embryo in vitro, it is necessary to adopt a culture microenvironment that approximates physiological conditions...
February 27, 2018: Molecular Human Reproduction
Leandro L Di Stasi, Carolina Díaz-Piedra, Juan Francisco Ruiz-Rabelo, Héctor Rieiro, Jose M Sanchez Carrion, Andrés Catena
BACKGROUND: Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost...
November 2017: Applied Ergonomics
Masaaki Yanishi, Hidefumi Kinoshita, Yuya Koito, Hisanori Taniguchi, Takao Mishima, Kaneki Yasuda, Yoshihiro Komai, Masato Watanabe, Motohiko Sugi, Tadashi Matsuda
The laparoscopic management of urachal remnants has gradually become a common practice. Recently, laparoscopic single-site surgery (LESS), a minimally invasive approach that provides excellent cosmetic results, has been adopted in several surgical procedures for treating urachal remnants. However, when suturing the bladder wall or peritoneal defect during LESS it may be difficult to conduct the procedure manually, and such cases require an additional port for suturing. Our strategy, however, employs a knot pusher to perform the suturing without the need for an additional port...
June 2017: Hinyokika Kiyo. Acta Urologica Japonica
Lea A Moukarzel, Abdulrahman K Sinno, Amanda N Fader, Edward J Tanner
STUDY OBJECTIVE: To compare operative times, surgical outcomes, and costs of robotic laparoendoscopic single-site (R-LESS) vs multiport robotic (MPR) total laparoscopic hysterectomy (TLH) with sentinel lymph node (SLN) mapping for low-risk endometrial cancer. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Academic university hospital. PATIENTS: Patients with a biopsy-proven diagnosis of complex atypical hyperplasia (CAH) or low-grade (1 or 2) endometrial cancer with body mass index <30 kg/m2 and undergoing robotic TLH and SLN mapping between 2012 and 2016 were included...
September 2017: Journal of Minimally Invasive Gynecology
Keiji Tomita, Susumu Kageyama, Eiki Hanada, Tetsuya Yoshida, Yuki Okinaka, Shigehisa Kubota, Masayuki Nagasawa, Kazuyoshi Johnin, Mitsuhiro Narita, Akihiro Kawauchi
OBJECTIVE: To study the efficacy of a new laparoscopic varicocelectomy technique using indocyanine green (ICG) angiography. METHODS: Laparoendoscopic single-site (LESS) varicocelectomy using ICG angiography was performed in a single institution on 11 patients with a grade 2 or 3 varicocele. Adult men (N = 9, 82%) who were apparently infertile and had a varicocele, as well as prepubertal boys (N = 2, 18%) with testicular growth retardation, underwent a LESS varicocelectomy using ICG angiography...
August 2017: Urology
H Najah, R Lo Dico, C Eveno, M Pocard
No abstract text is available yet for this article.
April 7, 2017: Journal of Visceral Surgery
Jannie Dressler, Lars N Jorgensen
BACKGROUND: Previous meta-analyses on the clinical outcome after laparo-endoscopic single-site surgery (LESS) versus conventional laparoscopic surgery (CLS) have not revealed any major differences in postoperative pain between the two procedures. This meta-analysis aims to evaluate the difference in postoperative pain between the two procedures, focusing on whether LESS was conducted with a non-expanding port (LESSnonex) or a port expanding (LESSex) within the incision. METHOD: EMBASE, Medline, PubMed, Science Citation Index Expanded, and Cochrane Central Register of Controlled Trials were searched for randomized clinical trials (RCTs) on LESS versus CLS for general abdominal procedures...
November 2017: Surgical Endoscopy
Stacey A Scheib
STUDY OBJECTIVE: To demonstrate a laparoendoscopic single-site (LESS) surgical approach to salpingectomy. DESIGN: A technical video showing step-by-step a LESS surgical approach to salpingectomy (Canadian Task Force classification level III). Institutional review board approval was not required for this study. SETTING: Of all gynecologic cancer types, ovarian cancer has the highest mortality rate and is the fifth leading cause of cancer deaths among women [1,2]...
February 2018: Journal of Minimally Invasive Gynecology
C Emi Bretschneider, Karl Jallad, Marie Fidela R Paraiso
Hysterectomy is one of the most commonly performed surgeries worldwide. Indication for hysterectomy is most often benign, which includes conditions such as prolapse, abnormal uterine bleeding, fibroids and pelvic pain. A broad range of surgical approaches exists for hysterectomy, ranging from open to minimally invasive techniques. Under this minimally invasive umbrella, the following techniques are included: vaginal hysterectomy, laparoscopic hysterectomy, and variations of those two techniques, such as laparoscopic-assisted vaginal hysterectomy, robotic-assisted hysterectomy, laparo-endoscopic single-site laparoscopic hysterectomy, mini-laparoscopic hysterectomy, and natural orifice transluminal endoscopic surgery hysterectomy...
June 2017: Minerva Ginecologica
Alexandre Buckley de Meritens, Julia Kim, Helen Dinkelspiel, Eloise Chapman-Davis, Thomas Caputo, Kevin M Holcomb
Single-site laparoscopy has proven to be a desirable option for patients undergoing gynecologic surgery, with some studies indicating improved cosmesis and less perioperative pain compared with standard approaches. This study describes the safety and feasibility of a novel robotic laparoendoscopic single-site surgery (R-LESS) platform as it is incorporated into a surgeon's practice with extensive multiport robotic surgical experience but limited LESS experience. We reviewed 83 women undergoing R-LESS by a single surgeon from September 2013 through August 2015...
February 2017: Journal of Minimally Invasive Gynecology
Geraldo José DE Souza Lima, Rodrigo Fabiano Guedes Leite, Gustavo Munayer Abras, Livio José Suretti Pires, Eduardo Godoy Castro
The role of laparoscopy in the modern surgery era is well established. With the prospect of being able to improve the already privileged current situation, new alternatives have been proposed, such as natural orifice endoscopic surgery (NOTES), the method for single transumbilical access (LESS - Laparo-endoscopic single-site surgery) and minilaparoscopy (MINI). The technique proposed by the authors uses a laparoscope with an operative channel like the flexible endoscope used in NOTES. All operative times are carried out through the umbilical trocar as in LESS, and assisted by a minilaparoscopy grasper...
May 2016: Revista do Colégio Brasileiro de Cirurgiões
J Micah Prendergast, Mark E Rentschler
INTRODUCTION: While autonomous surgical robotic systems exist primarily at the research level, recently these systems have made a strong push into clinical settings. The autonomous or semi-autonomous control of surgical robotic platforms may offer significant improvements to a diverse field of surgical procedures, allowing for high precision, intelligent manipulation of these systems and opening the door to advanced minimally invasive surgical procedures not currently possible. AREAS COVERED: This review highlights those experimental systems currently under development with a focus on in vivo modeling and control strategies designed specifically for the complex and dynamic surgical environment...
August 2016: Expert Review of Medical Devices
Mete Gungor, Ozguc Takmaz, Selim Afsar, Esra Ozbasli, Savas Gundogan
STUDY OBJECTIVE: To report the feasibility of bulky pelvic lymph node resection with robotic-assisted single-port laparoscopy in a patient with cervical cancer before chemoradiation therapy. DESIGN: Resection of pelvic bulky lymph nodes with a narrated video of da Vinci single-port platform surgery (Intuitive Surgical, Sunnyvale, CA) (Canadian Task Force classification III). SETTING: Although not enough evidence exists to reveal that single-site surgery is better than traditional endoscopic surgery, several studies have suggested that single-site robotic surgery has certain advantages such as less postoperative analgesic use, shorter hospital stay, and quicker recovery...
November 2016: Journal of Minimally Invasive Gynecology
Letizia Freschi, Nicola Pluchino, Stefano Angioni, Giovanna Simi, Maria Ruggiero, Vito Cela
AIMS: To present preliminary data of single-access laparoscopic surgery with a new device for the treatment of benign adnexal pathologies. METHODS: Ten women with benign adnexal pathologies underwent salpingectomy (n = 4) and ovarian/para-ovarian cyst enucleation (n = 6) using a laparo-endoscopic single-port approach with an innovative advanced multiport reusable trocar inserted transumbilically through a small wound retractor. Trocar introduction time, operative time, estimated blood loss, conversion to standard laparoscopy, peri- and postoperative complications, hospital stay and Visual Analog Scale score (as assessment of pain and cosmesis) were analyzed...
2016: Gynecologic and Obstetric Investigation
Alessandro Pontis, Federica Sedda, Liliana Mereu, Mauro Podda, Gian Benedetto Melis, Adolfo Pisanu, Stefano Angioni
PURPOSE: To critically appraise published randomized controlled trials (RCTs) comparing laparo-endoscopic single site (LESS) and multi-port laparoscopic (MPL) in gynecologic operative surgery; the aim was to assess feasibility, safety, and potential benefits of LESS in comparison to MPL. METHODS: A systematic review and meta-analysis of eleven RCTs. Women undergoing operative LESS and MPL gynecologic procedure (hysterectomy, cystectomy, salpingectomy, salpingo-oophorectomy, myomectomy)...
September 2016: Archives of Gynecology and Obstetrics
Deborah E Ikhena, Ajit Paintal, Magdy P Milad
STUDY OBJECTIVE: To determine the feasibility and role of abdominopelvic washings at the time of laparoscopic power morcellation and to determine if endometrial or myometrial tissue will be detected before and after laparoscopic power morcellation. DESIGN: A prospective pilot study (Canadian Task Force classification II-3). SETTING: An academic medical center. PATIENTS: All women who underwent laparoscopic myomectomy by a single provider at Northwestern Prentice Women's Hospital between August 2014 and October 2015...
July 2016: Journal of Minimally Invasive Gynecology
P León-Medina, A Blanco-Díez, D M Mejía-Chavarría, J V Armas-Molina, J Molina-Cabrillana, J L Artiles-Hernández
OBJECTIVE: Perform a comparative analysis of the outcomes of conventional laparoscopic adrenalectomy (LC) and the newly introduced laparo-endoscopic single-site surgery (LESS) over ten years. MATERIAL AND METHOD: We retrospectively reviewed the experience of a single surgeon from our medical centre with laparoscopic adrenalectomy, either through LC or LESS, with 75 patients between August 2005 and June 2015. Here we describe: age, sex, size, lateralization, preoperative diagnosis, total operating time, intraoperative bleeding, conversion to open surgery, mean hospital stay, intra- and postoperative complications and histopathology report...
May 2016: Actas Urologicas Españolas
An An Xu, Jiang Fan Zhu, Yuantao Su
INTRODUCTION: Knot tying is difficult but important for laparo-endoscopic single-site surgery (LESS). There are several techniques for LESS knot-tying. However, objective assessment of these skills has not yet been established. The aim of this study was to assess three different knot-tying techniques in LESS using mechanical methods. MATERIALS AND METHODS: The subject tied 24 knots, eight knots with each of the three techniques in an inanimate box laparoscopic trainer while the movements of their instruments were evaluated using a LESS mechanical evaluation platform...
October 2015: Journal of Minimal Access Surgery
Jiheum Paek, Jung-Dong Lee, Tae Wook Kong, Suk-Joon Chang, Hee-Sug Ryu
BACKGROUND: The aim of this study was to compare the surgical outcomes of robotic single-site (RSS) and laparo-endoscopic single-site (LESS) surgery for adnexal tumours and evaluate the feasibility of RSS surgery. METHODS: RSS surgery was performed using the da Vinci Single-Site® surgical platform and LESS surgery using a single multi-channel port system. Surgical outcomes were compared between RSS (n = 20) and LESS (n = 228) after 1:4 propensity score matching...
December 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
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