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Abstract The need for minimal invasive surgeries has been increasing through the last few years, even though laparoscopy is considered a minimal invasive surgery but researches has been going on to reach a more minimally invasive surgery emerging from the desire to utilize the advantages of laparoscopy over the open surgery and to avoid the complications recorded with it. The difficulties facing NOTES in the time being has pushed laparoscopists to search for a more applicable & suitable technique that fulfills the desired requirements. Many challenges faced - and still facing - the conversion from the conventional laparoscopy to LESS despite being successful in many experimental & clinical studies, the most important of which is the preservation of the concept of triangulation and obviating instrument collision that occurs on passage of multiple instruments in addition to an optic through a single incision. These challenges are being overcome through development of specialized platforms that fit the concept of LESS and preserves the principle of triangulation, including suitable access ports, working instruments and optics. 104 More recent technical developments helped facilitating LESS especially application of LESS through the Da Vinci Robotic Surgical System & the MAGS technology. Recently, LESS is being applied in many surgical specialties, and in urology is being applied (either conventional or robotic) in many surgical operations including Nephrectomies (simple, partial, radical & donor nephrectomy), Prostatectomy (Simple & Radical), Cystecomy, Uretrolithotomy, Uretroneocystostomy, Ilial Ureters, Varicocelectomy, Plus Repair of VVFs & Cryoablation of localized renal tumours. According to the clinical experiences and studies and that has been done around LESS, LESS has proved to be feasible, successful, safe & promising modality of intervention against different urological pathologies, although it is still considered in its infancy and still requiring more studies and more technical & instrumental development to help application on broader base of population and pathologies, that‟s why it is believed that in LESS there is “MORE”. |