Overcoming technical difficulties with single-port access laparoscopic surgery in gynecology: using conventional laparoscopic instruments.

AIM The aim of this report was to investigate ways to overcome technical difficulties of the single-port access (SPA) laparoscopic surgery using conventional laparoscopic instruments in gynecology. METHODS We performed 140 cases of SPA total laparoscopic hysterectomy for benign gynecologic diseases and 40 cases of two-port access laparoscopic surgery for gynecologic cancers. The conventional laparoscopic instruments, including a 45-cm-long, 5-mm-diameter, 30-degree-angled laparoscope, a 90-degree light cable adaptor, a curved instrument, and nonbulky trocars, and intracorporeal suturing and tying technique were used. RESULTS All operations were laparoscopically completed with no conversion to conventional laparoscopy or laparotomy. We obtained tolerable surgical outcomes with these instruments. CONCLUSIONS As the technical difficulties have been overcome, the SPA laparoscopic surgery will be a more and more widespread procedure in the gynecologic field with only minimal skin incision.

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