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Access techniques, platforms and instruments for LESS
Julien Guillotreau1, Sebastien Crouzet, Georges Pascal Haber
1Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Objectives:
To summarize the available tools available for performing LaparoEndoscopic Single-Site surgery in Urology.
Method:
A comprehensive electronic literature search was conducted in May 2011 using the Medline database to identify all publications relating to NOTES and LESS in urology and information on devices were also obtained by accessing company Websites.
Results:
Multiple access ports are available and allow to insert several instruments through multiple channels inside a larger single port. Due to lack of triangulation intracorporally, companies developed various articulating and bent instruments, limiting clashing and allowing increased working space. The ideal endoscope for LESS should remove the light cord and camera head from the operative field. Articulating and low profile scopes are now available. Furthermore, surgeons can use extra-long scopes.
Conclusion:
Various tools currently are available for single-site surgery. Randomized studies are needed to determine the Platform selection.
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