title: Robotic laparoendoscopic single-site surgery: the way forward.
abstract: OBJECTIVE
  LaparoEndoscopic Single-Site (LESS) surgery presents many technical and ergonomic obstacles. The solution to these current limitations may lie  within  emerging technologies, primarily the daVinci robotic platform. The purpose of this review was to examine the available literature as it pertains to robotic laparoendoscopic  single-site surgery (R-LESS) and detail our experience with this approach at our institution.
  
  
  METHODS
  An electronic literature search was conducted using the Medline database to identify all publications relating to R-LESS and/Mor robotic single port  surgery in urology. Additionally, a retrospective review of our single center experience was completed.
  
  
  RESULTS
  Fifteen original articles and two abstracts were identified in the literature and included dry lab investigation, animal experiments, single case reports, cumulative series, and two retrospective comparative analyses. Most detailed technique, perioperative outcomes, and associated procedural nuances.
  
  
  CONCLUSIONS
  R-LESS urologic surgery is feasible and can be performed using several approaches. R-LESS reduces difficulties encountered with conventional  LESS urologic surgery. An ideal robotic system is needed and would be task specific, deployable through a single incision, possess articulating instruments, and have  reduced external housings.
authors.affiliation: Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: White
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Shahab P
authors.initials: SP
authors.lastname: Hillyer
authors.forename: Gregory
authors.initials: G
authors.lastname: Spana
authors.forename: Jihad H
authors.initials: JH
authors.lastname: Kaouk
mesh_terms: D004724:Endoscopy / Q000639:trends*; D006801:Humans; D010535:Laparoscopy / Q000639:trends*; D057605:Natural Orifice Endoscopic Surgery / Q000639:trends; D012371:Robotics / Q000639:trends*; D013520:Urologic Surgical Procedures