title: Ergonomic and geometric tricks of laparoendoscopic single-site surgery (LESS) by using conventional laparoscopic instruments.
abstract: BACKGROUND
  The aim of this study was to explore the feasibility and safety of performing laparoendoscopic single-site surgery (LESS) with conventional laparoscopic instruments.
  
  
  METHODS
  We retrospectively reviewed our data from 175 patients who underwent various urological LESS procedures via the same ergonomic and geometric principles between 2008 and 2011. LESS procedures performed included adrenalectomy (N = 23), radical nephrectomy (N = 5), radical nephroureterectomy with bladder cuff resection (N = 5), varicocelectomy (N = 12), nephropexy (N = 4), lumbar sympathectomy (N = 4), orchiectomy for intra-abdominal testis (N = 1), pyeloureterostomy (N = 1), dismembered pyeloplasty (N = 1), and adult inguinal hernia mesh repair (N = 119).
  
  
  RESULTS
  All procedures were completed successfully without the use of ancillary ports or articulating instruments except two cases that required laparoscopic conversion. The mean patient age was 48.9 years. Mean operative time was 99.7 min, mean estimated blood loss was 17.3 ml, and mean hospital stay was 2.1 days. There were no intraoperative complications.
  
  
  CONCLUSIONS
  According to our ergonomic and geometric principles, use of conventional laparoscopic instruments is feasible and safe in LESS procedures.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan. tsai1970523@yahoo.com.tw
authors.forename: Yao-Chou
authors.initials: YC
authors.lastname: Tsai
authors.forename: Victor Chia-Hsiang
authors.initials: VC
authors.lastname: Lin
authors.forename: Shiu-Dong
authors.initials: SD
authors.lastname: Chung
authors.forename: Chen-Hsun
authors.initials: CH
authors.lastname: Ho
authors.forename: Fu-Shan
authors.initials: FS
authors.lastname: Jaw
authors.forename: Huai-Ching
authors.initials: HC
authors.lastname: Tai
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D006804:Ergonomics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies