title: LESS pyeloplasty & other reconstructive procedures.
abstract: OBJECTIVE
  To review and synthesize the evidence available in the literature on laparoendoscopic single-site (LESS) pyeloplasty and other reconstructive procedures.
  
  
  METHODS
  A literature search was performed to capture original articles related to LESS urological reconstructive procedures. We outlined the differences in technique and clinical outcomes related to their safety and efficacy.
  
  
  RESULTS
  We found 28 retrospective studies, with a total of 146 patients. Procedures included pyeloplasty (91), ureterolithotomy (44),  sacrocolpopexy (4),  bladder diverticulectomy (4), partial cystectomy (2), one of which associated to augmentation cystoplasty, ureteroneocystostomy (1), ileal ureter (1), and retrocaval ureter (1). Mean operative time was 215 minutes for LESS pyeloplasty and 186 minutes for  LESS ureterolithotomy. The mean estimated blood loss was 73 milliliters for pyeloplasty and 108 milliliters for ureterolithotomy. Mean length of stay was 2.7 days for pyeloplasty and 3.8 days for ureterolithotomy.
  
  
  CONCLUSIONS
  Urological LESS reconstructive surgery is feasible and safe for different procedures. A solid laparoscopic experience is strongly advised prior attempting LESS reconstructive procedures due to its technical complexity. Future studies should prioritize prospective and randomized designs comparing LESS with standard laparoscopy.
authors.affiliation: Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Humberto K
authors.initials: HK
authors.lastname: Laydner
authors.forename: José Alexandre P
authors.initials: JA
authors.lastname: Pedrosa
authors.forename: Rakesh
authors.initials: R
authors.lastname: Khanna
authors.forename: Wahib
authors.initials: W
authors.lastname: Isac
authors.forename: Rolbert J
authors.initials: RJ
authors.lastname: Stein
mesh_terms: D015653:Cystectomy / Q000379:methods; D004238:Diverticulitis / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D019651:Plastic Surgery Procedures; D014513:Ureter / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000601:surgery; D052878:Urolithiasis / Q000601:surgery; D014596:Uterine Prolapse / Q000601:surgery