Abstract

  We have started using laparo-endoscopic single-site surgery（LESS）in urologic surgery, although its use has not gained momentum due to its level of difficulty. We here report our initial experience with transumbilical LESS for adrenal tumor by using a single port with a multichannel cannula（SILS port）and bent laparoscopic instrumentation. The intraperitoneal space was approached through the umbilicus. The SILS port was placed through a 2 cm incision at the inner edge of the umbilicus. A 5 mm flexible laparoscope was introduced to keep the laparoscope outside, and surgical specimens were extracted using an Endocatch bag. The transumbilical approach in LESS for adrenalectomy is safe and feasible and also improves cosmetic outcome as a scarless surgery compared with standard laparoscopic procedures. Improvements in surgical devices may aid the further development of this approach.