Görker SEL

Our laparoscopic gynecological surgery experience through a single incision

Laparoscopic surgery has special importance for patients with cosmetic concerns. This cosmetic concern also reflects the willingness to take surgical approach as few incisions as possible. The aim of this study is to report the results of bilateral tubal ligation and salpingectomy with an incision of approximately 1 cm from the umbilicus and to introduce this simple and aesthetic technique. Between January 2018 and November 2018, 7 women were admitted to Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Obstetrics and Gynecology with a request for permanent contraception. Under general anesthesia, under sterile conditions, 1 mm infraumbilikal skin incision with a 5mm guide blade removed trocar was entered into the abdomen, insufflation of the abdominal cavity with 15 mm Hg pressure was inflated with carbon dioxide, pneumoperitoneum was provided. 5 mm, 30 degrees optical (Storz ®) trocar was entered into the abdomen. After removal of optic, bluntly penetrated from the same 1 cm skin incision, just next to the 5 mm trocar, if it does not penetrated the fascia, this procedure was performed by expanding the fascial entry with blunt and sharp dissection, followed by 5 mm laparoscopic LigaSure (Covidien ®) was entered into the abdomen through 5-mm trocar. In 7 cases; bilateral tubal ligation and, if necessary, salpingectomy were performed. The mean duration of the cases was 20 (+/- 5) and the time to enter the abdomen was 3 (+/- 1) minutes. Blood loss was negligible since the cases were short-duration minimally invasive cases. In our series of 7 cases, two patients underwent bilateral salpingectomy, in which single incision was not compelling to perform salpingectomy. As aesthetic concerns and the need to reduce the length of hospital stay with less incision and the need for costeffectiveness increase, these new methods will be developed, further.

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