Instruments and TechniquesSingle Port Access Laparoscopic Adnexal Surgery
Section snippets
Patients
Beginning June 25, 2008, SPA laparoscopic adnexal surgery was performed by a single gynecology surgeon (T.J. Kim) in 24 patients. Inclusion criteria were as follows: age < 70 years, an adnexal mass on ultrasonography or pelvic magnetic resonance image, and patients who consented to SPA procedures. Patients were excluded for adnexal tumors suspicious for malignancy, severe obesity (body mass index > 30 kg/m2), or patients who were at high risk for general anesthesia. Patient workup (history taking
Results
SPA laparoscopic adnexal surgery was successfully completed in 22 of 24 patients. The 2 failed cases were as follows: 1 required an additional trocar in the right lower quadrant of the abdomen for adequate adhesiolysis, and the other a staging laparotomy immediately after successfully finishing SPA laparoscopic oophorectomy because of the finding of a borderline ovarian malignancy on frozen section pathologic study.
Table 1 shows the patient characteristics and operative outcomes. The median age
Discussion
SPA laparoscopy was introduced to the field of gynecology for tubal sterilization about 4 decades ago [5]. However, SPA laparoscopic adnexal surgery did not gain widespread use because of the technical challenges associated with complex maneuvers intracorporeally for which there were no instruments available. Currently, with the availability of specialized instruments and multichannel ports, SPA laparoscopy has become a rapidly evolving field 8, 9, 10. Because the uterine manipulator through
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The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.
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Both of these authors contributed equally to this work.