Reduced-port surgery in gynecologic fields

Abstract

Reduced-port surgery (RPS) is widely used for various abdominal surgeries. In this paper, we review RPS as it applies specifically to the field of obstetrics and gynecology with a view toward its usefulness and future prospects. Due to an advisory that was issued by the U.S. Food and Drug Administration in May 2014 sales of the Johnson & Johnson Morcellex devices were discontinued, as a result a great number of institutions are forced to seek alternative methods of morcellation. Thus, we also approach the question of specimen retrieval during myomectomy. When RPS, including single-port surgery, is performed by a competent surgeon for established indications, it is superior to conventional laparoscopic surgery in cosmetic outcome, and it can also reduce pain and shorten the hospital stay. Although ligature manipulations can be problematic, sealing devices are useful for performing total hysterectomy and adnexectomy without ligature. Furthermore, using a single-port technique when it is possible to extend the umbilical incision, manual tissue morcellation is facilitated.

Keywords

• hysterectomy
• laparoscopy
• morcellation
• myomectomy
• reduced-port surgery