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World J Clin Urol. Jul 24, 2014; 3(2): 119-126
Published online Jul 24, 2014. doi: 10.5410/wjcu.v3.i2.119
Laparoscopic single site surgery: Experience in pediatric urology
Jonathan Wagmaister, Stanislav Kocherov, Boris Chertin
Jonathan Wagmaister, Stanislav Kocherov, Boris Chertin, Department of Pediatric Urology, Shaare Zedek Medical Center, the Faculty of Medicine, the Hebrew University, 91031 Jerusalem, Israel
Author contributions: All authors contributed to this work.
Correspondence to: Boris Chertin, MD, Head, Department of Pediatric Urology, Shaare Zedek Medical Center, the Faculty of Medicine, the Hebrew University, P.O.B 3235, 91031 Jerusalem, Israel. boris.chertin@gmail.com
Telephone: +972-2-6555560 Fax: +972-2-6555160
Received: December 19, 2013
Revised: March 5, 2014
Accepted: March 13, 2014
Published online: July 24, 2014
Processing time: 212 Days and 17.2 Hours
Abstract

Laparoendoscopic single-site surgery (LESS) has been developed to benefit patients by enabling surgeons to perform scarless surgery. In this review we aimed to summarize and critically analyze the available evidence on the current status and future prospects for LESS in pediatric urology, with special emphasis on our experience with LESS in children. The clinical data available clearly demonstrate that LESS can safely and effectively be performed in a variety of pediatric urology settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low; mostly being small case series or case-control studies from selected centers. Thus, the only objective benefit of LESS remains improved cosmetic outcome. Prospective randomized studies are awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technological advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics may be a driving force in the development of LESS.

Keywords: Laparoendoscopic single-site surgery; Pediatric urology; Laparoscopy; Review

Core tip: Laparoendoscopic single-site surgery (LESS) has been developed to benefit patients by enabling surgeons to perform scarless surgery. Clinical data demonstrate that LESS is safe and effective in many pediatric urology settings. As clinical experience increases, expanding indications are expected, along with improved efficacy. Prospective randomized studies are awaited to determine whether LESS procedures will be established as routine and will be able to stand the test of time. Technological advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS.