Since its introduction, the use of laparoendoscopic single-site surgery (LESS) for urologic indications has increased notably. This technique has not yet demonstrated superiority over conventional laparoscopy—with the exception of cosmetic outcomes. However, even this claim is based predominantly on subjective surgeon assessments and small sample sizes. A study by Park et al. used a patient survey methodology to compare the cosmetic outcomes of kidney surgery performed via LESS, laparoscopic or open techniques in 114 patients.

The authors developed a postoperative survey that comprised three main components: a body-image questionnaire to measure patients' perception of, and satisfaction with, their bodies; a photo-series questionnaire that required patients to score the cosmetic appearance of their scar; and three questions on the patient's preferences for a future surgical approach.

Patients who underwent LESS showed significantly higher median body image and cosmesis scores compared to those who underwent laparoscopic surgery or open surgery, respectively, and also rated their scars significantly higher than those in the laparoscopic and open surgery groups. 39% of participants stated that they would prefer to undergo LESS in the future (versus 33% and 4% for laparoscopic and open surgery, respectively). As expected, the preference for LESS decreased when its hypothetical risk of complications was increased by 5% or 10%.

The authors conclude that the scar outcomes of LESS are preferred to those of laparoscopic or open kidney surgery. As the LESS group tended to be younger and more likely to be undergoing surgery for a benign indication, the cosmetic benefits of surgery seem to be more highly valued by this demographic.