Laparoendoscopic single-site surgery (LESS) prostatectomy--robotic and conventional approach

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Laparoendoscopic single-site surgery (LESS) is an evolving minimally invasive technique.
• Prostatectomy, including radical and simple procedures, is increasingly performed using advanced surgical methods.

Purpose of the Study:

• To review preliminary advances in LESS for prostatectomy, both robot-assisted and robot-independent.
• To analyze current publications on LESS prostatectomy in animal models and human patients.

Main Methods:

• Comprehensive literature search of Embase and Medline databases (1966-2008) and urological meeting abstracts.
• Inclusion of studies on prostatectomy using keywords related to LESS, robotics, and specific surgical systems.
• Analysis of publications with no language restrictions.

Main Results:

• LESS prostatectomy, with or without robotic aid, is technically feasible but poses significant challenges.
• Robotic systems like the da Vinci Surgical System can mitigate ergonomic issues, reduce instrument clash, and enhance precision.
• Preliminary oncological control data is limited, and cosmetic improvement is the primary proven advantage.

Conclusions:

• LESS prostatectomy demonstrates technical feasibility with potential ergonomic benefits, especially with robotic assistance.
• Further advancements, including flexible robotic platforms, may enhance feasibility and acceptance of LESS for radical prostatectomy.
• Current evidence does not conclusively demonstrate advantages beyond cosmesis, pending further research on oncological outcomes.