Laparoendoscopic Single-Site Surgery in Gynecologic Oncology

Laparoscopy is the surgical approach of choice for many gynecologic oncology procedures. Reduced morbidity, shorter hospitalization, and a more rapid recovery have been associated with minimally invasive surgical approaches when compared with laparotomy. Incisional morbidity, including vascular and viscous injury, postoperative hernia, infection, and pain remain important concerns. Use of fewer and smaller incisions during laparoscopy may be expected to further minimize these risks. Laparoendoscopic single-site surgery (LESS), or single-incision laparoscopy, describes the use of one small skin incision to complete laparoscopic surgical procedures. Despite having pioneered the use of single-incision laparoscopy for performance of tubal sterilization, gynecologic surgeons faced technical limitations that prompted the use of multiple incisions for completion of more complex procedures. Recent advances in instrumentation have provided the opportunity to revisit the concept of laparoscopic surgery limited to use of a single incision.