Single-Access Laparoscopic Approach for Gynecological Surgery

In the last decades, minimally invasive surgery has taken a leading role in the treatment of benign and malignant gynecological pathology. The introduction at first of laparoscopy and then of da Vinci robotic system has made possible the improvement of morbidity and surgical outcomes in the gynecological surgery. The last goal in minimally invasive surgery has been to get better cosmesis results and to decrease the postoperative pain reducing the size and number of ports needed to complete the surgical procedures. Laparoendoscopic single-site surgery (LESS) contemplates the use of a single skin incision within the umbilicus instead of the multiple ports created in the traditional laparoscopy. The development of technology and the introduction of new laparoscopic instruments have allowed to improve the application of LESS surgery in many surgical specialties. The published literature has showed that it was possible to overcome some technical challenges, making LESS safe and feasible in the achievement of complex surgery. However, new trials and data are needed to define the long-term surgical outcomes.