Reduced-port surgery in gynecologic fields

Abstract

Reduced-port surgery (RPS) is widely used for various abdominal surgeries. Herein, we review RPS as it applies specifically to the field of obstetrics and gynecology with a view toward its usefulness and future prospects. Because an advisory was issued by the US FDA in May 2014 and sales of the Johnson & Johnson Morcellex devices were subsequently discontinued, a great number of institutions will be forced to see 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 terms of the cosmetic outcome, and it can reduce pain and shorten the hospital stay. Ligature manipulations can be problematic, but sealing devices are useful for performing total hysterectomy and adnexectomy without ligature. Furthermore, by using a single-port technique when it is possible to extend the umbilical incision, manual tissue morcellation is facilitated.

Feasibility of reduced port surgery applying Higuchi's transverse incision

“…In addition, in April 2014, the United States Food and Drug Administration issued a warning regarding the safety of power morcellators typically used in laparoscopy for uterine fibroids, thus posing problems for the surgical procedure and fibroid removal. 13 14 …”