Reduced-port surgery in gynecologic fields

• Main Authors: Iwaho Kikuchi, Jun Kumakiri, Yoichi Aoki, Uki Ujihira, Kaoru Tejima, Yoko Tsuzuki, Aiko Sakamoto, Juichiro Saito, Michio Nojima, Koyo Yoshida, Satoru Takeda
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-11-01
• Series: Gynecology and Minimally Invasive Therapy
• Subjects: hysterectomy; laparoscopy; morcellation; myomectomy; reduced-port surgery
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213307015001057

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.