Journal of Gynecological Endoscopy and Surgery
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REVIEW ARTICLE
Year : 2011  |  Volume : 2  |  Issue : 1  |  Page : 11-17

Single-port access laparoscopic hysterectomy: A new dimension of minimally invasive surgery


1 Department of Gynecology, Centro Oncologico Fiorentino, Sesto Fiorentino, Italy
2 Department of Gynecology, Centro Oncologico Fiorentino, Sesto Fiorentino; Department of Obstetrics and Gynecology, Universitą degli Studi di Cagliari, Cagliari, Italy
3 Department of Gynecology, Centro Oncologico Fiorentino, Sesto Fiorentino; Department of Obstetrics and Gynecology Universitą Cattolica del Sacro Cuore, Roma, Italy

Correspondence Address:
Mereu Liliana
Centro Oncologico Fiorentino, Via A. Ragionieri 101, Sesto Fiorentino (Fi)
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1216.85273

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The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach.


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