LaparoEndoscopic Single-Site Upper Gastrointestinal Surgery

Abstract

The evolution of minimally invasive surgery has led to the development of laparoendoscopic single-site (LESS) surgery. The feasibility of almost all types of LESS upper (GI) procedures has been shown. During the learning phase, substantial experience in both laparoscopy and upper GI surgery and stringent patient selection criteria is essential for successful and safe application of the technique, especially in complex procedures. Comparative studies between LESS and conventional laparoscopy for various upper GI procedures suggest a non-inferiority of LESS over standard laparoscopy, although the only objective benefit remains an improved cosmetic outcome. Intracorporeal instrument collision, lack of triangulation, and in-line vision are among the main challenges of LESS surgery. The current review provides a comprehensive report of the specific applications of LESS in upper GI surgery, with a special reference to advances made to overcome the current technical difficulties and future perspectives.