Is LESS really more?

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Laparoendoscopic single-site surgery (LESS) emerged as a potential advancement in minimally invasive surgery.
• The primary goals of LESS include reduced pain, morbidity, and improved cosmesis due to fewer incisions.

Purpose of the Study:

• To objectively assess and compare the efficacy and outcomes of LESS versus standard laparoscopic surgery.
• To evaluate whether LESS offers significant advantages over conventional laparoscopy, particularly concerning cosmesis and patient-reported outcomes.

Main Methods:

• A comprehensive review of existing literature comparing LESS and standard laparoscopic techniques.
• Objective assessment of data regarding complications, surgical costs, operative times, and cosmetic outcomes.

Main Results:

• LESS publications often focus on demonstrating equivalence to laparoscopy, with a strong emphasis on cosmetic results.
• Evidence suggests LESS may be associated with increased complication rates, higher costs, and longer operative times.
• Objective data supporting cosmetic superiority in LESS is often lacking, despite patients prioritizing other factors.

Conclusions:

• The purported benefits of LESS, especially regarding cosmesis, require more robust objective validation.
• Current evidence does not definitively establish LESS as superior to standard laparoscopy, raising questions about its overall value beyond cosmetic considerations.