History: From Open Surgery to LESS Surgery

The entire history of surgery has always been determined by the idea of reducing the invasiveness and morbidity of an operation and by the dream of scar-free surgery. But, for a long time, surgical procedures were performed as open surgeries with long cuts. Therefore, surgery was associated with painful incisions, longer recovery times and quite large residual scars. Over the past 25 years, these conditions improved – especially due to evolving new techniques.

A landmark advance was achieved by the introduction of laparoscopy in the 1980s – a minimally invasive surgical (MIS) procedure. In laparoscopy, the surgeon performs the operation with special long and thin surgical instruments that he inserts through 3 to 5 small incisions (0.5 to 1.5 cm in size). To be able to carry out the surgical interventions, the surgeon requires a laparoscope that provides him with a detailed picture of the abdominal cavity and one or more hand instruments. During the surgical procedure, the abdominal cavity is inflated with inherent gas (carbon dioxide) so that the surgeon has a better view of the organs.
After the procedure, the instruments are removed, the gas released and the small incisions closed.
Compared to traditional open surgery with its long cuts, laparoscopy reduces the size of the entry sites. This way laparoscopic surgery produces the same surgical result as open surgery, but improves post-surgical comfort including reduced pain, decreased risk of infections and wound complications, shorter hospital stays, faster recoveries and return to daily routine. Last but not least, laparoscopy achieves a better cosmetic result: compared to open surgery, only tiny scars are left behind. Since its discovery, laparoscopy has established itself in hospitals as a standard procedure and is employed on a routine basis.
Since the establishment of laparoscopy, the development in MIS has been constantly evolving. A great advance in the field of minimally invasive surgery is now Laparo-Endoscopic Single-Site surgery – abbreviated LESS.