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Robotic LESS Approaches

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Minimally Invasive Urology

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Abstract

Laparoendoscopic single-site surgery (LESS) has been developed to further minimize the morbidity associated with laparoscopic surgery. By reducing the number and length of skin incisions, it was hypothesized that this would lead to less pain, faster convalescence, and improved cosmesis following minimally invasive surgery. However, LESS requires considerable laparoscopic experience and stringent patient-selection criteria to achieve successful outcomes. It was postulated that the benefits of robotic surgery could be applied to LESS (R-LESS) to overcome some of the challenges. We reported the first clinical R-LESS series (which included a radical prostatectomy) and noted an improved ability to perform dissection and intracorporeal suturing, due to the stability and articulation of the robotic instruments. The application of the robotic platform with its EndoWrist technology and superior HD 3D optics has further addressed the challenges seen with conventional LESS. However, R-LESS-specific platforms are needed to fully realize the potential benefits of robotic surgery for this application. Further clinical study is required to determine the precise role of this technique in the realm of minimally invasive urologic surgery. In this chapter we outline patient selection, positioning, surgical tools, and techniques for R-LESS.

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Author information

Authors and Affiliations

  1. Glickman Urologic and Kidney Institute, Department of Laparoscopic and Robotic Surgery Cleveland Clinic, Cleveland Clinic, 9500 Euclid Avenue/Q10-1, Cleveland, OH, 44195, USA

    Dinesh Samarasekera MD

  2. Department of Urology, Cleveland Clinic, Cleveland, OH, USA

    Jihad H. Kaouk

Authors
  1. Dinesh Samarasekera MD
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  2. Jihad H. Kaouk
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Corresponding author

Correspondence to Dinesh Samarasekera MD .

Editor information

Editors and Affiliations

  1. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

    Sara L. Best

  2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

    Stephen Y. Nakada

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Samarasekera, D., Kaouk, J.H. (2015). Robotic LESS Approaches. In: Best, S., Nakada, S. (eds) Minimally Invasive Urology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1317-6_11

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  • DOI: https://doi.org/10.1007/978-1-4939-1317-6_11

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1316-9

  • Online ISBN: 978-1-4939-1317-6

  • eBook Packages: MedicineMedicine (R0)

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