Issues in application of laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery in gynecology

Abstract

Compared with the conventional multiport laparoscopy, laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) have shown their advantages in the postoperative cosmetic effect, which promotes the rapid development of these technologies in gynecology in recent years. LESS and transvaginal NOTES (vNOTES) are more difficult to operate and both have longer learning curves than multiport laparoscopy. A comprehensive understanding of the operative techniques in LESS may facilitate its wider application. Currently LESS and vNOTES are used mostly for treatment of benign gynecological diseases, and their application in treatment of malignancies remains challenging and controversial. Some robotic platforms overcome the limitation of human hands, and may represent the future direction of gynecological surgeries.

Keywords

• laparoendoscopic single-site surgery
• robotics
• transvaginal natural orifice transluminal endoscopic surgery
• small-triangle manipulation