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LESS: Ports, Optics, and Instruments

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Atlas of Laparoscopic and Robotic Single Site Surgery

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Laparoendoscopic single-site surgery (LESS) represents a progression toward decreasing the invasiveness of minimally invasive surgery. By decreasing the number of port site locations to a single access, scars can be readily concealed within the umbilicus or the extraction site. However, such single-site access is associated with loss of triangulation and introduces increased difficulty. The past 5 years has witnessed much advancement in ports, optics, and instruments, altered in an attempt to mitigate such difficulties. Low profile, silicone, and multiport trocars have been developed to decrease internal clashing of instruments. Optic improvements include the introduction of videoscopes that are sufficiently long, articulate, or have the camera and light source streamlined into a single low profile handle. Pre-bent and articulating instruments provide the ability to regain triangulation lost with the single-site access. Advancements in adaptation of the da Vinci robotic surgical system (and novel robots) to LESS has removed the mental challenge of directing a sided instrument with contralateral hand and will likely allow for greater penetration into practice.

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Author information

Authors and Affiliations

  1. Department of Surgery, Division of Urology, Rutgers – Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Sammy E. Elsamra MD

  2. Departments of Urology and Radiology, University of Alabama at Birmingham, Birmingham, AL, USA

    Soroush Rais-Bahrami MD

  3. Urology Department, The Hofstra – North Shore LIJ School of Medicine, Lake Success, NY, USA

    Lee Richstone MD

Authors
  1. Sammy E. Elsamra MD
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  2. Soroush Rais-Bahrami MD
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  3. Lee Richstone MD
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Corresponding author

Correspondence to Lee Richstone MD .

Editor information

Editors and Affiliations

  1. Professor of Surgery, Department of Urology Cleveland Clinic Lerner, College of Medicine, Zagarek Pollock Chair in Robotic Surgery, Center for Robotic and Image guided Surgery, Glickman Urologic Institute, Cleveland, Ohio, USA

    Jihad H. Kaouk

  2. Associate Professor of Surgery, Department of Urology, Center for Robotic and Image Guided Surgery, Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, Ohio, USA

    Robert J. Stein

  3. Associate Staff, Department of Urology, Center for Robotic and Image Guided Surgery, Glickman Urological Institute Cleveland Clinic, Cleveland, Ohio, USA

    Georges-Pascal Haber

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Elsamra, S.E., Rais-Bahrami, S., Richstone, L. (2017). LESS: Ports, Optics, and Instruments. In: Kaouk, J., Stein, R., Haber, GP. (eds) Atlas of Laparoscopic and Robotic Single Site Surgery. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-3575-8_4

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  • DOI: https://doi.org/10.1007/978-1-4939-3575-8_4

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-3573-4

  • Online ISBN: 978-1-4939-3575-8

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