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Laparoendoscopic Single-Site Surgery in Gynecology: A Review of the Literature, Tools, and Techniques

Bradford, Leslie S. MD*; Boruta, David M. MD

Obstetrical & Gynecological Survey:
doi: 10.1097/OGX.0b013e318286f673
CME Articles: Gynecologic Laparoendoscopic Surgery
Abstract

Recent decades have witnessed a tremendous shift from laparotomy to laparoscopy as the surgical approach of choice in gynecology. Completion of increasingly complicated procedures has been facilitated by technical advances in instrumentation. Lately, increasing attention has been paid to reducing both the number and size of laparoscopic incisions, with the ultimate goal being the absence of any visible scar. Laparoendoscopic single-site surgery (LESS), or single-incision laparoscopy, describes the use of 1 small skin incision to complete laparoscopic surgical procedures where traditionally multiple incisions were created. In addition to examining the developing literature related to LESS in gynecology, the aims of this review were to describe the technical challenges encountered during performance of LESS and to provide practical solutions for instrumentation and surgical techniques that allow them to be overcome.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to identify potential benefits of LESS, and implement practical solutions for instrumentation and surgical techniques to overcome technical challenges faced during LESS.

Author Information

*Clinical Fellow, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA; and †Assistant Professor of Obstetrics and Gynecology, Harvard Medical School, Boston, MA

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: David M. Boruta, MD, Massachusetts General Hospital, Yawkey Center, Suite 9E, 55 Fruit St, Boston, MA 02114. E-mail: dboruta@partners.org.

© 2013 by Lippincott Williams & Wilkins.