Introduction: To report our experience with some advanced laparoendoscopic single-site (LESS) abdominal surgery. Methods: Between July 2008 and September 2009, we perform LESS abdominal procedures in 42 patients for various indications. This included acute appendicitis with peritonitis, acute cholecystitis, cystogastrojejunostomy for pancreatic pseudocyst, resection of giant mesenteric cyst, gastrojejunostomy, sleeve gastrectomy, splenectomy and a perforated duodenal ulcer. Data was prospectively collected. All procedures were performed using several port devices and a combination of standard and roticulating laparoscopic instruments. Results: In the study period, LESS procedures conversion to standard multiport laparoscopy was necessary in 2 cases, none to open surgery. No intraoperative complications occurred. The operative time was similar to standard procedures and the hospital stay was remarkable shorter than multiport operations. Conclusions: The advanced LESS surgery is technically feasible for a variety of ablative and reconstructive applications in abdominal surgery. With proper patient selection, conversion and complications rates are low. Technology and instrumentation improvement are likely to expand the role of LESS in minimally invasive complex procedures.
Program Number: P538