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Frequently Asked Questions
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 1. In which surgical fields is LESS surgery possible?
2. Can LESS surgery be applied on children?
3. Is the LESS procedure painful?
4. Is there an increased risk for complications?
5. If complications do occur during a LESS surgical procedure, can the surgeon switch to conventional surgical techniques?
6. Is it possible that during surgery more incisions than the one for the LESS port will be necessary?
7. How long do you have to stay in hospital after LESS surgery?
8. When can you get up after a LESS surgery?
9. How soon can I return to work after a LESS surgery?
10. Does the scar require special treatment, e.g. ointment?
11. Is the bellybutton more sensitive or more vulnerable after a LESS surgery?
12. Do any stitches have to be removed, and if so, when?
13. Can the scar in the bellybutton become a problem? Does it hurt or can the scar chap?
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1. In which surgical fields is LESS surgery possible?
LESS surgery can have a very broad spectrum of application. Experience is available from various disciplines, for example, paediatric surgery, urology, gynaecology, hepatobiliary (liver) surgery and gastrointestinal (abdominal) surgery.
In general, the treating physician will decide on a case-to-case basis if LESS surgery is the appropriate surgical method for you.
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2. Can LESS surgery be applied on children?
Based on current scientific publications and research studies, LESS surgery can also be suitable for operations on children.
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3. Is the LESS procedure painful?
Physicians like Jihad Kaouk, MD (Cleveland, Ohio, USA) report that patients who undergo surgery by the LESS method seem to complain less about pain because only one incision has been made through their abdominal wall (1). Of course, as with every surgical procedure, there will be a certain amount of pain, but since the number of wounds is reduced, the pain can be less severe.
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4. Is there an increased risk for complications?
Preliminary results of current scientific studies show that the risk for complications during LESS surgery seems comparable with the risk in standard laparoscopic procedures (Gill et al. 2009, in press).
Although the approach may differ, LESS procedures apply the same rules as standard laparoscopy.
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5. If complications do occur during a LESS surgical procedure, can the surgeon switch to conventional surgical techniques?
Yes, and that is how it should be. Placement of an additional trocar alone can be sufficient in most cases to manage potential complications. The guiding principle is that patients’ safety is paramount.
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6. Is it possible that during surgery more incisions than the one for the LESS port will be necessary?
That might be possible. Particularly in obese (overweight) patients, circumstances may arise where it can be very helpful to insert an additional trocar through a second entry point. This will facilitate the surgeon’s work and makes it easier for the surgeon to confidently identify organ structures and then complete the procedure in the LESS technique.
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7. How long do you have to stay in hospital after LESS surgery?
This can vary greatly depending on the nature and extent of the procedure performed. There is no general rule.
In some European countries, the length of hospital stay may even be dictated by the reimbursement system. That often means that the doctor may not discharge the patient that same evening, but has to wait until the next day.
Nevertheless, it may be feasible for patients to be discharged on the same day after minor LESS operations, such as gynaecological procedures.
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8. When can you get up after a LESS surgery?
This depends on which procedure has been performed. However, many patients can get up and move around on the same afternoon after LESS operations. In other words, they can get out of bed for the first time within the first five hours after the procedure.
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9. How soon can I return to work after a LESS surgery?
That varies from patient to patient. Many patients are able to return to work within a week. Of course, this also depends on the nature and the extent of the operation.
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10. Does the scar require special treatment, e.g. ointment?
After operations performed around the bellybutton, the dressing should be kept dry for the first 5 days. Normally, no special treatment of the scar is required.
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11. Is the bellybutton more sensitive or more vulnerable after a LESS surgery?
That depends on the patient. Normally, the bellybutton is not very sensitive. However, this fact might change after a LESS surgery.
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12. Do any stitches have to be removed, and if so, when?
Normally, absorbable suture materials are used for the procedure. These sutures dissolve by themselves and do not have to be removed. That offers a big advantage for patients, say, with a "deep" bellybutton, where it can be difficult to remove stitches from the umbilical furrow. In the event that sutures do indeed need to be removed, then this normally takes place after between 8 and 10 days.
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13. Can the scar in the bellybutton become a problem? Does it hurt or can the scar chap?
As such, the bellybutton is a scar. It closes by itself at birth when the body’s natural rejection of the remaining umbilical cord closes the opening with what is the equivalent of a scar. Physicians have not reported that previously operated patients have complained about problems with their bellybuttons. Nevertheless, this aspect still needs to be monitored in long-term follow-up studies.
(1) Swanstrom, LL et al., Advancing the future of minimally invasive surgery. General Surgery News, Special Report; 2009 Feb:1-8.
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