Consortium Establishes Criteria for Single-Port Surgery

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A multidisciplinary consortium of 28 surgeons from the United States and around the world convened for a one-day closed-door brainstorming meeting at Cleveland Clinic on July 7. The consortium's goal was to establish an approach to advance responsibly the rapidly growing field of single-portal laparoscopic surgery.

The group of surgeons—from the fields of urology, obstetrics and gynecology, and bariatric, general, and colorectal surgery—focused on charting a course forward re-garding innovations in surgical techniques, instrumentation, technology, collection of data, and collaboration with other societies.

The following decisions emerged from the meeting:

Terminology

The consortium concluded that the term Laparo-Endoscopic Single-Site Surgery (LESS) most accurately conveys the broad philosophical and practical aspects of the field. There exists understandable con-fusion regarding terminology in this emerging field. Given its potential for rapid growth, consensus on terminology was of immediate importance.

To select the most appropriate name/designation for this field, the consortium believed the selected name should indicate and encompass the following broad criteria: (a) single-entry portal, (b) location: abdomen, pelvis, thorax, (c) laparoscopic, endoscopic, or robotic surgery, (d) umbilical or extra-umbilical, (e) extraluminal or transluminal (percutaneous single-portal access) surgery, and (f) have a broad reach so as to be inclusive, not exclusive.

Additionally, the Laparo-Endoscopic Single-Site Surgery Consortium for Assessment and Research (LESSCAR) was created. This group is organized in a manner similar to that of the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR), which seeks to advance the field of natural orifice transluminal endoscopic surgery (NOTES).

Web-based secure database registry

All clinical LESS cases would be entered prospectively into an international database open to all LESSCAR members and associated organizations and approved by the Institutional Review Board. This database will incorporate necessary checks and balances to ensure data accuracy, which will form the basis for future clinical research studies.

Liaison with other surgical societies

LESSCAR will seek to collaborate with various established professional surgical societies with a view to advancing the field. An effort will be made to coordinate research and increase awareness of developments in LESS procedures with other established major leadership surgical societies. As the clinical applications of LESS expand, LESSCAR will facilitate introduction of various specialties to the new techniques and technology.

Annual meetings

LESSCAR will schedule meetings in conjunction with other professional organizations that may benefit from an exchange of knowledge on the subject.

White paper

Details of the inaugural meeting of LESSCAR are in the process of being published in a comprehensive white paper. A semi-annual LESS newsletter is also planned.

Training courses

“Hands-on” LESS training dry lab and live animal courses specific to each specialty are being planned.

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