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.