Transumbilical endoscopic surgery: History, present situation and perspectives

Area of Science:

• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Transumbilical endoscopic surgery, or laparo-endoscopic single site (LESS) surgery, represents a significant development in 21st-century minimally invasive surgical techniques.
• This technique has seen increasing application across various abdominal conditions, including morbid obesity and hernia repairs.

Purpose of the Study:

• To review the history, current status, and future perspectives of transumbilical endoscopic surgery.
• To discuss the nomenclature associated with this surgical approach.
• To evaluate the potential of LESS surgery in replacing traditional laparoscopic procedures.

Main Methods:

• Literature review of transumbilical endoscopic surgery.
• Discussion of current applications and nomenclature.
• Analysis of potential future adoption rates based on expert consensus (LESSCAR).

Main Results:

• Transumbilical endoscopic surgery has broad applicability in abdominal procedures.
• Expert consensus suggests 50%-80% of laparoscopic surgeries could transition to transumbilical approaches within five years.
• Significant advancements in instruments have been made, but safety remains paramount.

Conclusions:

• Transumbilical endoscopic surgery is a rapidly evolving field with considerable potential.
• Prioritizing cosmetic improvements over proven safety is cautioned against.
• Multicenter, randomized clinical trials are crucial to establish the definitive safety and efficiency of LESS surgery.
• Further research on new instrument efficacy is needed to navigate the complex market landscape.