LESS Excision of Seminal Vesicle Cyst of the general population and are usually associated with ipsilateral renal agenesis or with ipsilateral ectopic ureter- al insertion [3]. Most cases of congenital seminal vesicular cysts are asymptomatic and do not require treatment. However, they do rarely cause symptoms and signs, includ- ing perineal pelvic pain, post-ejaculatory pain, hema- tospermia, infertility, and voiding problems [2,5]. Surgical treatment should be considered when constant and in- tractable symptoms are present. 　Abdominopelvic and transrectal ultrasound is the initial diagnostic tool for long-standing pelvic pain and suspicious physical findings [6]. A CT scan can be used as a second di- agnostic tool to detect concurrent renal agenesis and fur- ther define any pathological pelvic processes. Additional studies may include intravenous pyelogram (IVP), pelvic magnetic resonance imaging (MRI), and seminovesiculo- graphy. Cystoscopy may identify an absent ipsilateral hemitrigone, intravesical cyst protrusion, and any other anatomial abnormality of the bladder [1]. 　The current treatment of choice for seminal vesicular cysts is surgical excision. Conventional open surgery is con- sidered a definitive treatment. However, it is associated with significant morbidity, such as bladder wall laceration and ureteral injury [6]. Recently, many medical centers have reported successful laparoscopic excisions of seminal vesicular cysts [1,3,6]. The laparoscopic approach is mini- mally invasive and can provide an excellent direct retro- vesical view of the deep seminal vesicle [7]. LESS is an evolving technique for minimally invasive surgery that has been applied in certain urological procedures [8]. LESS has been applied to simple and radical nephrectomy, nephrour- eterectomy, ureterolithotomy, ureterectomy, and partial cystectomy. However, there have been no previous reports on LESS for seminal vesicular cyst excision. Most of the ini- tial difficulties with these procedures were the results of poorly adapted instruments and platforms that disrupted soft tissue handling and caused instrument clashing. These difficulties caused a steep learning curve for surge- ons. Cumulative experience has allowed surgeons to over- come many of these difficulties, and operative times for LESS are now similar to those for traditional laparoscopic surgeries [9]. As described here, we successfully performed LESS for excision of a symptomatic seminal vesicular cyst. 　Conventional laparoscopic excision of seminal vesicular cysts is the common treatment modality. Recently, LESS has been tried as a new method of management in urologic surgery. Retrospective analysis has not demonstrated an advantage of LESS compared with standard laparoscopy, 433 although prospective randomized trials are necessary to further determine the advantages and disadvantages of this technique [10]. We believe that an adequately powered prospective randomized comparison between LESS and standard laparoscopy will demonstrate superior cosmetic results and faster recovery with LESS than with the stand- ard laparoscopic surgery. In this study, we evaluated the feasibility and effectiveness of the LESS approach for a symptomatic seminal vesicular cyst. We conclude that the LESS approach can be performed for excision of a sympto- matic seminal vesicular cyst. Conflicts of Interest The authors have nothing to disclose. REFERENCES 1. Cherullo EE, Meraney AM, Bernstein LH, Einstein DM, Thomas AJ, Gill IS. Laparoscopic management of congenital seminal vesi- cle cysts associated with ipsilateral renal agenesis. J Urol 2002; 167:1263-7. 2. 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