Critical review of laparoendoscopic single-site surgery versus multiport laparoscopy in urology

Continued advancement in laparoscopy and a desire for less-invasive surgical approach has led to the development of novel surgical approaches, including laparoendoscopic single-site surgery (LESS). LESS in urology has not reached the pinnacle yet. Objective of this study is to provide an evidence-based analysis of the current status and future directions of minimal access and minimally invasive urological surgery represented by LESS in comparison with classic multiport laparoscopic surgery. Since the initial report of single-port nephrectomy in 2007, the majority of laparoscopic procedures in urology have been described with a single-site approach. Multi-center experience has validated Urological LESS procedures as technically feasible and safe for various urologic diseases. Certainly, several issues must be overcome before LESS can practiced universally in urology. Development of instrumentation and platform, long term follow up and large-scale randomized controlled trials are needed to provide an accurate comparative analysis with other procedures to confirm the significant benefits of LESS.