The technical challenges of laparoendoscopic single-site surgery (LESS) stem from the nonideal instrument configuration in which all of the instrumentation is inserted through a single small incision and are greater than those faced when using conventional laparoscopy (CL). LESS configuration results in more instrument collisions, an in-line view of the instruments, and the surgeon's close proximity to assistants [1–3]. These limitations of LESS procedures and its related technologies that, along with possible increased physical risk to the surgeon, currently limit the standardization and universal adoption of this pioneering technique [4]. Minimally invasive surgery (MIS) which includes LESS is very appealing to the patient for the immediate outcomes including reduced scarring and recovery time [5–8]. Scarring in LESS is isolated to one incision within the umbilicus compared to four small incision scars resulting from CL. Although both types of surgery...

References

References
1.
Rivas
,
H.
,
Varela
,
E.
, and
Scott
,
D.
,
2010
, “
Single-Incision Laparoscopic Cholecystectomy: Initial Evaluation of a Large Series of Patients
,”
Surg. Endoscopy
,
24
(
6
), pp.
1403
1412
.10.1007/s00464-009-0786-7
2.
Saber
,
A. A.
,
Elgamal
,
M. H.
,
El-Ghazaly
,
T. H.
,
Dewoolkar
,
A. V.
, and
Akl
,
A.
,
2010
, “
Simple Technique for Single Incision Transumbilical Laparoscopic Appendectomy
,”
Int. J. Surg.
,
8
(
2
), pp.
128
130
.10.1016/j.ijsu.2009.12.001
3.
Teixeira
,
J.
,
McGill
,
K.
,
Koshy
,
N.
,
McGinty
,
J.
, and
Todd
,
G.
,
2010
, “
Laparoscopic Single-Site Surgery for Placement of Adjustable Gastric Band—A Series of 22 Cases
,”
Surg. Obes. Relat. Dis.
,
6
(
1
), pp.
41
45
.10.1016/j.soard.2009.03.220
4.
Brown-Clerk
,
B.
,
De Laveaga
,
A. E.
,
LaGrange
,
C. A.
,
Wirth
,
L. M.
,
Lowndes
,
B. R.
, and
Hallbeck
,
M. S.
,
2011
, “
Laparoendoscopic Single-Site (LESS) Surgery Versus Conventional Laparoscopic Surgery: Comparison of Surgical Port Performance in a Surgical Simulator With Novices
,”
Surg. Endoscopy
,
25
(
7
), pp.
2210
2218
.10.1007/s00464-010-1524-x
5.
Li
,
X.
,
Zhang
,
J.
,
Sang
,
L.
,
Zhang
,
W.
,
Chu
,
Z.
,
Li
,
X.
, and
Liu
,
Y.
,
2010
, “
Laparoscopic Versus Conventional Appendectomy—A Meta-Analysis of Randomized Controlled Trials
,”
BMC Gastroenterol.
,
10
(
1
), p.
129
.10.1186/1471-230X-10-129
6.
Lee
,
J.
,
Baek
,
J.
, and
Kim
,
W.
,
2010
, “
Laparoscopic Transumbilical Single-Port Appendectomy: Initial Experience and Comparison With Three-Port Appendectomy
,”
Surg. Laparoscopy Endoscopy Percutaneous Tech.
,
20
(
2
), pp.
100
103
.10.1097/SLE.0b013e3181d84922
7.
Tsimoyiannis
,
E. C.
,
Tsimogiannis
,
K. E.
,
Pappas-Gogos
,
G.
,
Farantos
,
C.
,
Benetatos
,
N.
,
Mavridou
,
P.
, and
Manataki
,
A.
,
2010
, “
Different Pain Scores in Single Transumbilical Incision Laparoscopic Cholecystectomy Versus Classic Laparoscopic Cholecystectomy: A Randomized Controlled Trial
,”
Surg. Endoscopy
,
24
(
8
), pp.
1842
1848
.10.1007/s00464-010-0887-3
8.
Garg
,
P.
,
Thakur
,
J. D.
,
Garg
,
M.
, and
Menon
,
G. R.
,
2012
, “
Single-Incision Laparoscopic Cholecystectomy vs. Conventional Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials
,”
J. Gastrointest. Surg.: Off. J. Soc. Surg. Aliment. Tract
,
16
(
8
), pp.
1618
1628
.10.1007/s11605-012-1906-6
9.
Park
,
A.
,
Lee
,
G.
,
Seagull
,
F. J.
,
Meenaghan
,
N.
, and
Dexter
,
D.
,
2010
, “
Patients Benefit While Surgeons Suffer: An Impending Epidemic
,”
J. Am. College Surg.
,
210
(3), pp.
306
313
.10.1016/j.jamcollsurg.2009.10.017
10.
AAMI,
2009
, “
Human Factors Engineering—Design of Medical Devices
,” Association for the Advancement of Medical Instrumentation, Arlington, VA, Standard No. ANSI/AAMI HE75:2009.
11.
AAMI,
2007
, “
Medical Devices—Application of Usability Engineering to Medical Devices
,” Association for the Advancement of Medical Instrumentation, Arlington, VA, Standard No. ANSI/AAMI/IEC 62366:2007.
12.
McCrory
,
B.
,
Lowndes
,
B. R.
,
Wirth
,
L. M.
,
de Laveaga
,
A. E.
,
LaGrange
,
C. A.
, and
Hallbeck
,
M. S.
,
2012
, “
Ergonomic Evaluation of Laparoendoscopic Single-Site Surgery Ports in a Validated Laparoscopic Training Model
,”
Work: A J. Prev., Assess. Rehab.
,
41
(S1), pp.
1884
1890
. 10.3233/WOR-2012-0402-1884
You do not currently have access to this content.