Surgeons have been striving to minimize scarring from surgical procedures. Open surgery has been replaced by laparoscopy with the added benefit of reducing scarring. The next step in improving postsurgical cosmesis is to leave no scar. Companies that manufacture medical devices are investing in natural orifice transluminal endoscopic surgery (NOTES). This procedure remains in an early experimental phase. Although it achieves the concept of scarless surgery, it requires iatrogenic opening of a viscus for access. Alternative endoscopes and instruments also add financial costs. A practical step toward scarless surgery is to use a laparoscopic modification using only the umbilicus, through which a single multichannel port (12 mm) is inserted, leaving no visible scars postoperatively.
MacDonald ER, Ahmed I. Another Step Toward Scarless Surgery. Arch Surg. 2009;144(6):591–595. doi:10.1001/archsurg.2009.95
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