Laparoendoscopic single-site surgery, minilaparoscopy and natural orifice transluminal endoscopic surgery in urology

This article reviews the development of laparo-endoscopic single-site surgery (LESS), minilaparoscopy (MiniLap), and natural orifice transluminal endoscopic surgery (NOTES) with a particular focus on the applications in urologic surgery. We also provide the reader with a focused summary of the relevant nomenclature, history, and comparative outcomes. A literature search was conducted on LESS, MiniLap, needlescopy, microlaparoscopy and NOTES procedures in urology which is current through January 2013. The most relevant contemporary publications were selected and the pertinent findings were reviewed. Over the last few decades, we note that many innovative surgeons have performed a myriad of urologic procedures using LESS, MiniLap and NOTES techniques. These techniques are beginning to garner interest throughout the world; however, the enthusiasm for said techniques, while high, has not yet been met with high level scientific data clearly demonstrating the advantages of these approaches over conventional laparoscopy. In this review, we outline the history and clinical implementation of these techniques while also reviewing the comparative data where it exists. We attempt to provide the reader with a balanced overview of these techniques, their origins and lay the groundwork for future research and development.